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After a trip to Europe and New Zealnd (which involved 5

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Hello,After a trip to Europe...
Hello,After a trip to Europe and New Zealnd (which involved 5 weeks of binge drinking), I have come back with severe depersonalisation. It first hit me in New Zealand where I suddenly felt spaced out and unable to concentrate (a familiar feeling I have had before, generally after no sleep all night.) I felt extremely detatched and there was a sort of out-of-body experienceI thought after a good night's rest it would go away. However, it did not. It's now been 2 1/2 months and It's worsening. I'm beginning to feel as though people around me and my surrounding are not real.It is worth mentioning, my brother did the same trip and during week 3 or 4 he was hit with this same thing. For him it has been a year and he still has it - not as bad as it aas, but it is still there.Is there any solution to this issue? Thanks.- Chad
Submitted: 9 months ago.Category: Neurology
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Customer reply replied 9 months ago
I ALSO HAD AN MRI SCAN AND RESULTS WERE ALL NORMAL**
Answered in 28 minutes by:
11/16/2017
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 9 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,410
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi Chad, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I am sorry to hear about your & your brother’s health situation in the form of the symptoms you have mentioned above. Please see this appears a very rare health situation but as a neurologist I can try to help you with the diagnosis & treatment of this unusual type of health situation.

I am currently preparing & typing my answer and I will post my answer here as soon as it is ready.

Best Regards!

Dr Subbanna MD

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 9 months ago

I am almost done with my typing; I will follow up with you very soon.

Best Regards!

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 9 months ago

Once again, this type of health situation is rare. But I will try to provide you with few diagnostic possibilities to consider and their management plan too.

First of all, you were binge drinking alcohol, and this may have caused vitamin b1 (Thiamine) deficiency

Thiamine deficiency can cause various forms of cognitive and mental manifestations.

Couple of such conditions caused by thiamine deficiency are very severe and serious in nature and these conditions are called as Wernicke’s encephalopathy & Korsakoff psychosis

These conditions are the most severe forms that occur due to thiamine deficiency and people who drink are susceptible to develop these conditions. Since this occurred during the binge drinking phase so it is a possibility to consider

Although I am not suspecting the exact above mentioned severe conditions, the description you have provided above does not sound like you have had the above mentioned severe conditions, but there are relatively minor conditions that can cause cognitive and mental manifestations due to thiamine deficiency and this is a possibility to consider

However if your brother was not drinking when this happened then this is a very less likely possibility to consider, although in your case this possibility still needs to be considered because of the use of alcohol.

Another possibility to consider is possible poisoning of some kind, for example certain types of heavy metal poisoning can do this (lead, mercury etc).

But then the question will arise whether both of you got poisoned? It appeared to me you guys travelled at different times, if this is so then it is difficult to consider this possibility, although poisoning especially due to heavy metal exposure needs a consideration in these situations, and if not already done then there are certain blood and urine tests are available to explore these possibilities and if poisoning is diagnosed then there are chelating agents available to get rid of these poisons from the body.

Another possibility to consider is, some type of viral illness, that is presenting as encephalitis to explain the brain related symptoms you guys have been having, but then again both are having similar issues and this is difficult to explain, but this possibility needs a consideration too. I see you have had mri scan of the brain which is normal so this rules out the possibilities such as stroke, tumors etc, but mild grades of encephalitis etc can be missed on the mri scan and in this regard the most useful test is a spinal tap (also called as LP or Lumbar puncture) and this test can help in ruling out encephalitis conditions. So if a spinal tap has not already been done then please discuss with your neurologist possibly conducting this neurological test.

And for the possible vitamin b1 or thiamine deficiency – if not already done – then you guys may try to take high dose of thiamine. It should be available as over the counter and the initial dose is about 100 to 200 mg per day, and then depending upon the response the dose can be adjusted.

And there is another form of vitamin b1 called as Sulbutiamine, and this form of vitamin b1 is thought to enter the brain better than the thiamine form, so if possible you guys may try to use sulbutiamine and it can be more effective compared to the thiamine.

In addition to thiamine supplementation you guys may also try certain additional nutritional supplements such as the following ones;

Methyl Guard Plus (which is a combination of active forms of vitamin b12, vitamin b9/folate, vitamin b6, vitamin b2)

ALA (Alpha lipoic acid)

Acetyl L Carnitine

Coenzyme Q10 etc

These above mentioned nutritional supplements too can help with faster recovery

I earnestly hope you find the above information & treatments helpful.

Wishing you guys a quick & complete recovery! And also Wishing you guys the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Customer reply replied 9 months ago
Hi Subbanna,Wernicke’s encephalopathy is something i did a bit of research on (which terrified me, haha) but my GP advised me this would not be the case? Is there a way to test for thyamine deficiency? And is wet brain permanent? I have had blood tests and they all appeared fine, also.
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 9 months ago

hello sir, whole blood Test measuring of TDP (Thiamine Diphosphate) is the current best test for checking thiamine deficiency – so if this has not been done then you may ask your dr to arrange for this test.

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Customer reply replied 9 months ago
My GP advised this was tested for and is all okay.. Sorry to be a pain, but where would you recommend i go from here?
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 9 months ago

I have analysed your case thoroughly again, and I feel I do not have any additional information to add to what I had already provided earlier. I really wish I had more to offer but I am sorry I do not. So I have decided to Opt-Out from your case and give another expert a chance to help you with your case.

Please avoid replying to this post, otherwise this question may get locked back to me again and prevent other experts from taking up your question.

All the very best!

Best Regards!

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Neurologist: Dr. David, Board Certified MD replied 9 months ago
Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 50,128
Experience: Experienced physician in Neurology
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This is Dr. David

I see the other doctor has opted out

it sounds like your testing has been normal so far

how long have you had these symptoms. it sounds like you have had these symptoms of anxiety and depersonalization before you went on your trip?

when did you get the brain MRI scan?

how long have you been binge drinking? this is not good for your health and over time can injure your brain?

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Customer reply replied 9 months ago
No, I did not have these symptoms before the trip. About week 4 into the trip (when I was completely sober) i was in the middle of a conversation with my friends, and in the middle of laughter I felt a sudden feeling of detatchment. Its the same feeling I used to get when I would stay up all night with no sleep. The feeling stayed with me, and due to that feeling i started to feel anxiety and depersonalisation. I was fine up until week 4 of my trip.
I do not binge drink often at all. I would only go out every 2nd weekend or so. But during this trip I drank almost every night - as most do on Contiki trips.
Customer reply replied 9 months ago
I got the MRI 2 days ago.
Neurologist: Dr. David, Board Certified MD replied 9 months ago

I see

excessive drinking can cause changes in your brain and can cause detatchment, loss of attention and concentration, loss of focus for periods of time.

bad anxiety symptoms can make you more worried about symptoms.

I would avoid alcohol for now

if you continue to have bad anxiety symptoms, you may benefit from medications to help decrease anxiety symptoms.

you may benefit from seeing a psychotherapist for psychotherapy and talk therapy which could help

you should focus on eating healthier at this point and getting some regular exercise which can help your brain work better and help you sleep better at night time

regular exercise can help you have less anxiety symptoms

things like yoga, and deep breathing exercises, meditation can help you decrease anxiety symptoms and help your brain function better

let me know if you have questions.

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