Patient: Description of condition (onset, main symptoms, hospital visited, etc.): On May 19, I felt weakness in my arms and legs and my whole body. At first, I thought it was a cold, so I took some cold medicine, but on the 20th, my speech became unclear and I had convulsions. After that, the hospital in the region to see, no effect later on the 25th transferred to a large hospital, to that side began to fever 37.5 degrees to 39.8 degrees, has been playing Valium, in the treatment there about 22 days no change, the doctor said it was hopeless, and then transferred to a small local hospital, back the next day people woke up, the fever receded. I have not seen any effect Now I have been discharged home, and I can talk, but I am sometimes confused and sometimes awake, and I don’t sleep at night. He is also very thin. Seems to be speech unintelligible again.
Patient: Hello! Dr. Shih, do you have a fax? I can fax you the medical records?
Patient: May 26 cerebrospinal fluid examination stain – looking for antacid bacilli – not seen, gram stain – gram stain looking for pathogenic bacteria – no pathogenic bacteria seen. June 4 cerebrospinal fluid cerebrospinal fluid glucose result is 5.60. cerebrospinal fluid chloride 115.0. cerebrospinal fluid lactate dehydrogenase 30.8. cerebrospinal fluid lunar quanxi deaminase 0.2. cerebrospinal fluid protein 0.23. June 4 herpes simplex virus antibody type I M Herpes simplex virus antibody type I M negative (-), herpes simplex virus antibody type II M negative (-), tuberculosis antibody negative (-)
Patient: general bacterial culture + fungal culture + drug sensitivity was done on June 4 showing no fungal growth no bacterial growth. EEG showed generalized moderate abnormal EEG. Actually the doctor there used drugs like vancomycin, folepin, teicoplanin, moxifloxacin, imipenem, etc. The most used was mannitol and dehydration every day. We actually don’t know if it’s viral encephalitis or not?
Patient: Hello! Dr. Shih, what oral medications are available? In fact, what kind of condition does he have? Will it come back? In fact, we are already very confused. What kind of injection do I need to go to the hospital? I feel that the current doctor there is not very responsible, even the condition is very and we have said.
Patient: Hello! Dr. Shi, my brother is now no more menstrual cramps, that is, he does not sleep much during the day at night. The MIR examination is written as follows: punctate long TI long T2 signal foci are seen in the right basal ganglia area with clear margins, and no obvious abnormal signal foci are seen in the rest of the brain parenchyma, and the brain gray and white matter signal contrast is clear. The brainstem morphology was normal in size with uniform signal, the ventricle morphology was normal in size, the cerebral sulcus and fissure were clear as usual, the midline structure was centered, no occupying lesions were seen in the saddle area, the signal was normal in the bilateral cavernous sinus area, bilaterally, the auditory nerve travel was regular with normal thickness, long T2 signal foci could be seen in the bilateral middle ear mastoid airspace, and the pterygoid sinus mucosa was hypertrophied. Diagnosis: 1, cavernous foci in the right basal ganglia area. 2. bilateral middle ear mastoiditis 3. pterygoid sinusitis
Patient: Hello! Dr. Shih, there is no Valium medication all bought in the market, except this Valium medication. Are there any other medications? Thank you for your help.
Patient: Hello! Dr. Shih, he often feel very tired now, what is going on ah!
Patient: Hello! Dr. Shi, my brother can sleep now, but he always wants to go out to work, because we all have given him Chinese medicine, because he does not eat scared, even boiling soup for him, so these two days did not eat, I do not know if it is the reason for not eating. He is now very temperamental, sometimes with great force, and wants to go out with his own backpack. Let him come back, he is not happy struggling, kicking around. Oops! Now he has a headache, and he won’t go for a review. I wanted him to have his ears checked.
Patient: Hello! Dr. Shih, thank you for your continued patience. I’d like to ask if he needs to be watched more often and can’t be left alone.
Patient: Hello! Dr. Shi, my brother is very sweaty now, always full of sweat, and sometimes he drools in his sleep at night, is it yin deficiency! Because he always feels tired, are there some herbs that can treat it, his whole body looks normal now, he just doesn’t like to try to do other things much. We are afraid he will be autistic. Please help!
Patient: Hello! Dr. Shi, he now does not want to go out, always stay at home, sometimes people ask him, he is too lazy to answer, drugs and other he does not eat, she said he is not sick, so he does not even drink soup.
Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: Hello, this disease is a bit strange. It would be better to provide me with the results of head CT, EEG and cerebrospinal fluid at that time. At first glance, the medical history you provided is to consider encephalitis, but at the same time, other diseases should be excluded. Encephalitis can sometimes have dramatic changes and get well very suddenly, but it can also have sequelae.
Haisan Shi, Department of Neurology, Guangzhou Brain Hospital: Sorry, there is no fax. You took a picture with your camera and uploaded it online.
Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: Hi, looking at this report of cerebrospinal fluid, there is nothing wrong, the chloride is a little bit lower. It looks like a viral infection. It doesn’t seem to be fungal. Are there any EEG results?
Haisan Shi, Department of Neurology, Guangzhou Brain Hospital: Hi, looking at the information you provided, a lot of advanced antibiotics were used, was it combined with a severe pneumonia at the same time? The use of a lot of mannitol should be severe cerebral edema caused by epilepsy. Based on the history you provided, I guess the doctors should be considering encephalitis. It is still rather severe and should have sequelae. Now that you have been discharged from the hospital, you need to keep taking oral medication for a while. Enhance brain exercise, for example, play chess, cards, read books, sing, etc.
Guangzhou Brain Hospital, Department of Neurology, Shi Haisan: Hello, the oral medications are usually nerve-nourishing drugs, such as brain rejuvenation, brain rejuvenation, cytarabine, ergotoxine, etc. If you have epilepsy, you should take anti-epileptic drugs, such as carbamazepine, sodium valproate, etc. You have not provided a CT scan of the skull. It is better to take some medications to improve cognitive function, such as Haberin, Ansonia, Amlexan, Meperidine, etc. Some patients may be in status epilepticus all the time, pay attention to review EEG.
Haisan Shi, Department of Neurology, Guangzhou Brain Hospital: Hello, we have seen the MRI results, which suggest that there is damage to the brain parenchyma. It is recommended to continue to take some oral neurotrophic drugs for a period of time. You can add some drugs for sleep, such as Valium. After half a year, we will review the MRI to see if the lesion has disappeared.
Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: Hello, Valium drugs should be prescribed in the hospital.
Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: Hi, I guess the patient feels very tired, which may be related to encephalitis or medication. It’s hard to judge because I didn’t see the patient.
Shi Haisan, Department of Neurology, Guangzhou Brain Hospital.
It is very common for patients to have temper changes after encephalitis, after all, it is a serious brain injury, which has to be recovered slowly. If necessary, you can take oral mood stabilizing drugs, such as sodium valproate.
Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: It is not completely impossible to leave, some of the things he can do by himself, can let him finish by himself. Just don’t let him do dangerous things alone.
Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: After encephalitis, there will always be some differences from before, physical and personality changes. It takes time to recover. Insist on taking neurotrophic drugs. If you have symptoms of depression, you can take oral antidepressants. It is best to visit the hospital.