Viruses

Question: My sister was diagnosed with West Nile Virus two years ago. (She gave blood and received a post card in the mail alerting her that her blood carried the virus.) She has had neck stiffness, muscle aches, a twitch in her arm, memory loss, and a rash with scabs on her arm. She still has scabs on her arm, the twitch, stiffness, etc. Today she had a neurological exam where she couldn't remember hot to draw a face of a clock showing 10 minutes after 9. She said that her writing looked like a kindergartner's and chicken scratch. She is 51 years old and cannot remember how to sign on to her computer. She shies away from groups or taking phone calls .... Dr. ordered an MRI. This has been going on for two years, could this be a result of West Nile? Any help you can offer would be greatly appreciated. She works full time and still drives and takes care of household responsibilities. Her boss changed her to an hourly employee and noticed a change in her behavior and work. Something is wrong and it is hard to imagine that it is not somehow related to the virus as that is when her symptoms started.

Answer: I am sorry to hear about your sister contracting West Nile virus. I do believe that some of the symptoms your sister is having could be related to West Nile virus. Unfortunately, there is not a treatment, that I am aware of. Seeing a neurologist is a good idea so that any other causes of her symptoms, including the memory loss, can be ruled out. There may be other treatment that are available that I am not aware of.

Here is a website from the Centers for Disease Control that discusses West Nile Virus. http://www.cdc.gov/westnile/symptoms/index.html

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Question: I am a 40 year old male, who was accepted for rehabilitation about a year ago, but insurance refused to cover the treatment so I didn't get the treatment. Since then my condition has worsened to the point where I have to be in a wheelchair part-time at home and full-time out and about. 

I personally believe that the head injuries as a child, without any real treatment, along with contracting recurrent viral meningitis at age 21 has caused my recent decline and ongoing health issues. I also believe that my seizures are from the recurrent viral meningitis, and not psychological, even though I have mental health diagnosis. I recently had surgery, and after upping my lysine dosage a week before the surgery the seizures became less frequent. I have seen several different psychologists, but get contradicting stories. One will say I am in horrible shape, and the next will say I am coping just fine. My wife and I believe that my mental health is under control. 

So I have a few questions if you don't mind answering from a neuroscientist point of view.
Could the recurring viral meningitis cause seizures that are not epileptic, but also not be psychological?

My wife believes my decline is consistent with CTE, and my neurologist said it is possible. Along with multiple head injuries, I would bang my head into walls, desks, etc. when frustrated until my late 30's. Do you think at this point trying to determine if CTE is part of my problems is worth the time and effort to find out?

I have heard people get diagnosed with CTE while alive, but have also heard that isn't possible. Can you be diagnosed with CTE while living?

Speaking with an epidemiologist from the CDC, he said he believes the mental health diagnosis could be comorbid due to the recurrent viral meningitis. Do you agree that is a possibility?

I also spoke with Dr. Jon Stone in Scotland, expert in FNsD, and he said having Mollaret's Meningitis makes me highly likely to get FND. I wonder if my symptoms are really just due to the Mollaret's Meningitis, or that has caused another disease?

It seems to me that having the meninges around your brain constantly, or regularly, enflamed could cause all kinds of neurological symptoms.

Answer: Viral Meningitis can cause seizures. I am not sure what you mean by "that are not epileptic". Do you mean that these seizures are not convulsive in nature? People can have "absence" seizures which means that the brain is having a seizure but there may be no outward signs of a seizure. Most of the time these individuals just look like they are spacing out. An EEG can usually detect these types of seizures.

Currently, there is not a definitive method to determine if a living person has CTE. And even if there was a way to diagnose it, I am not sure the treatment would be any different for it than what it would be for any other brain injury. Rehabilitation, counseling (for depression and anxiety which are symptoms that have been reported in people who have CTE), medications to treat other co-morbid medical conditions, and a strong support system.

Yes, I agree that a mental health diagnosis might occur along with viral meningitis. It might depend on the type of mental health illness that we are talking about. Depression, anxiety would seem to fit but perhaps other mental health diagnoses might not fit.

Functional neurological disorder (FND) sounds like any other brain injury that could have been caused by meningitis, a traumatic brain injury, etc. Often times we cannot structurally see damage to the brain with the current tools that are available (CT, MRI), but yet these individuals still have very real deficits that were due to their injury. These issues can be psychological (anger, irritability, depression, anxiety), physical (fatigue, increased pain, headaches, dizziness), and/or cognitive (memory, attention, problem solving issues). I think people are using the term FND to capture these issues, although I think it negates the severity of the issue. Why not just call disorders what they are....traumatic brain injury, meningitis, etc.  
 


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