Patient's Query
Hi doctor,
My brother was admitted to the hospital with a chest infection. He is classified as an alcoholic, as he drinks more than the recommended daily allowance, but he only consumes beer and not spirits.
About a week before his hospitalization, he began speaking nonsensically, and he now seems to have lost both his long-term and short-term memory. He has since been placed in a care home. He is 65 years old.
Before he was discharged from the hospital, he underwent a brain scan, which appeared normal. Based on past experience, I know that when my brother becomes ill, he tends to stop drinking and eating. He typically does not seek hospital care until he is seriously unwell, so by the time he was admitted, he would have likely been undernourished and dehydrated.
When he was discharged, the medical staff suggested that his memory might return, although it could take time. It has now been two months, and there has been no improvement. It seems he is being classified as having dementia.
I have two questions:
Does dementia develop that quickly?
I have been researching possible conditions, and the only one that seems to match his symptoms is wet brain (Wernicke-Korsakoff syndrome). If someone has very low thiamine levels, will taking a daily vitamin B supplement be sufficient to raise those levels?
Please guide.
Hi,
Welcome to icliniq.com.
I can understand your concern.
I understand your concerns.
Dementia typically does not manifest suddenly within a week. Alzheimer's dementia progresses slowly over months or years. A sudden change following a chest infection suggests an acute condition rather than typical dementia.
In a person who drinks heavily and likely stopped eating before being admitted, we should strongly consider Wernicke-Korsakoff syndrome, commonly referred to as "wet brain." This syndrome occurs due to a severe deficiency of thiamine (vitamin B1).
In the early stage, known as Wernicke's, symptoms may include confusion, balance issues, and sometimes vision problems. If not treated promptly, this can progress to the Korsakoff stage, which leads to severe memory loss and the tendency to fabricate stories. The belief that he is on a cruise aligns closely with this condition.
A normal brain scan does not rule out Wernicke-Korsakoff syndrome; in many cases, an MRI (magnetic resonance imaging) can appear normal. The diagnosis is primarily clinical.
Regarding thiamine levels, if the level is very low, simple oral vitamin B tablets may not suffice. In suspected cases, high-dose intravenous thiamine is typically required during hospitalization. Oral tablets are more suitable for maintenance and not for addressing severe deficiencies.
If intravenous thiamine is delayed, some memory issues may become permanent. However, this differs from typical age-related dementia.
The family needs to confirm whether he received high-dose intravenous thiamine during his hospital stay, as this is very important.
If you found this information helpful, I would greatly appreciate your feedback. Wishing you comfort and steady improvement ahead.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
His son contacted the hospital today, but they would not disclose what treatment his father had received since he is no longer an inpatient. My brother is unable to request this information himself, so we are at a standstill in retrieving these details. I am trying to assist my nephew, who has ADHD and suffers from anxiety and depression, and is struggling to cope with this situation.
Please guide.
Hi,
Welcome back to icliniq.com.
Thank you for updating me.
This is understandably very stressful for your nephew. I can help guide you through this process.
First, it is important to know that hospitals cannot share medical information without the patient’s consent.
Family members can request treatment records if the patient lacks capacity and can demonstrate that they are acting in the patient’s best interests. This request should be made in writing to the hospital’s medical records department.
Given your nephew’s attention-deficit/hyperactivity disorder (ADHD) and anxiety, it is crucial to recognize that this situation can be overwhelming for him. Here are some suggestions that may help:
From a medical perspective, it is reasonable to want to know whether intravenous thiamine was administered. That information is important and should be obtainable through official channels. You are doing a great job supporting him.
I hope this helps address your query. Please provide your valuable feedback to improve patient care.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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