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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience:  U.S. Physician/Surgeon in Neurosurgery
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i need help. my mom last year lost her ablity to move her ...

Customer Question

i need help. my mom last year lost her ablity to move her left side it started slowly from her finger then the arm and slowly to her leg. we took her to the doctor she did not have a stroke. she has rapid eye movement, a uti that just keeps comming back even with anti-bioatics. a strong smell from her urine and is constipated.she is now in the hospital she had a seizure. The thing that baffles us the most is she has lost 4 family memebers to this and now has a sister in israel. all of the family members were all diagnoised mpms symptoms are seizures, confused,inablity to move her left side,uti, constipation,abdominal pain,loss of speech,swelled up ankels,non responsive sometimes, and was rushed to the hospital due to high grade fever. the doctors have given us so many different answers. My mom is now laying in the hospital for over a month and still no answer.please please help my mom...iris
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Mark replied 8 years ago.
While I'm sure it already has been done, did they get a MRI of the brain with and without contrast to look for anything?

Inability to move the left side starting with the hand, then to the arm, then to the leg is suggestive of something causing problems with the right parietal lobe, growing slowly. The fact that she had a seizure also points to the fact that something is irritating the brain cortex (surface). Although the seizure could have come from other things, such as electrolyte imbalances, fever (from the UTI), medications, the fact she also has focal (one sided) weakness is concerning.

The key to the diagnosis here is what is happening within her brain at this time. Do you or can you get a copy of the Brain MRI report?
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Customer: replied 8 years ago.
Reply to Dr. Mark's Post: yes i could get a copy of her mri.They did mention that she may have white matter disease.the sistuation is complicated because of so many siblings. One of her brothers had gone to the doctor for a uti and was given meds which didnt help he also started to lose ablity to talk and walk and then slipped into a coma. the doctors wanted to give up his son refused and thats when they did a brain byopsy. he was diagonsed with the herpies virus syndrome. He was given anti bio and has made a full recovery.Is it pissible my mom has the same thing? they wanted to do a spinal tap to find out? is there any other way of knowing if she has this virus? and are the symptoms the same? when we told the doctor he was kind of iffy about it..
Expert:  Dr. Mark replied 8 years ago.
That condition is known as "herpes encephalitis" and could be a possibility, though you describe a long process of left sided weakness, and typically the herpes encephalitis is of quicker onset (over days). It can cause seizures as well, but does not usually just affect one side of the brain and body (encephalitis usually affects both sides of the brain).

White matter disease on a MRI is a relatively common finding as you get older, and usually the result of years of high blood pressure, but would not cause the symptoms you are describing either.

A spinal tap to get the spinal fluid to test for infection and elevated proteins could be helpful if they are suspicious of an infection causing her mental status decline. They can also test the fluid for viral DNA if they suspect herpes virus infection.
Customer: replied 8 years ago.
Reply to Dr. Mark's Post: one last question. one doctor in pa mentioned whipples disease. the symptoms are all there. I know that whipples is a rare disease found outside of the U.S. MY mom was born and spent most of her childhood years in morrocco. Your opinion is it possible? does whipples make more sense in her situation with her symptoms? these are the two things we are looking at. I know that the spinal tap would give me a more accurate diagonis but im scared she is going to move while they do the procedure.she has a tube in her throat and coughs a lot because of it.
Expert:  Dr. Mark replied 8 years ago.
The one symptom that your mom has that doesn't fit with Whipple's disease is that her weakness happens to be on one side of the body only; when weakness happens on one side of the body only, it is suggestive of something occuring on the opposite side of the brain.

The weakness in Whipple's disease and other systemic diseases is global, or all through the body. A focal (meaning one specific part of the body) weakness is suggestive of a specific lesion/problem.

While this is certainly very low down the list of possibilities, it never hurts to suggest it to her doctor's to see if they agree or disagree.

The lumbar puncture is a safe procedure, as it actually is in a part of the spinal canal where there are only nerves, and not the actual spinal cord, so even if she were to move, the risk of injury to a nerve is still very small. I have done lumbar punctures on very agitated patients before without much difficulty.