Dr. Gursimran Singh
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My brother had COVID-19, and it developed into encephalitis. The neurologists are saying it could be viral or limbic. We wonder if you can help diagnose if we sent you the MRI images and laboratory reports. His symptoms are confusion (he thinks that his kids are his brothers), hallucinations, muscle weakness, and insomnia (he did not sleep for six days). Now he is taking Acyclovir. He has been in this situation for the past 40 days.
Hi,
Welcome to icliniq.com.
Sorry to know regarding this problem that your brother is facing. After reading the history and checking his reports (attachment removed to protect patient identity), viral encephalitis is more likely given the MRI images. And the hallucination and psychosis are because of encephalitis. He saw the condition that he had COVID-19, and his immunity must have been lower. Herpes encephalitis is a more substantial possibility. Treatment should be intravenous Acyclovir 10 to 15 mg/kg for 14 days. At least is he eating food and able to tell about bowel and bladder habits? Does he understand what you are talking about, what time and day it is? How often is he getting a fever? One CSF (cerebrospinal fluid) report is not correct amongst all the reports.
Patient's Query
Hi doctor,
Thank you for your reply.
He is eating; he has no fever and tells about bowel and bladder. His functions are excellent. He understand what he hears; he watches television and interacts about the program. Thank you again, and I look forward to your reply.
Hi,
Welcome back to icliniq.com.
It is good that he is eating and can do his regular daily chores. That means he will be fine after this. In total, he should take Acyclovir (10 to 15 mg/kg for 14 days) for 14 days intravenously. Is the discharge already? Tablet Valacyclovir 1 gram thrice daily for seven days should be given after discharge.
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Neurology
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