Neurologist Recommendation.

[pauleddy]

About six months ago I was taken to ER because I had fallen down some stairs at home. There was a bit of blood and I was mildly concussed. The SHO sent me home after my Glasgow Coma Scale remained unremarkable. I had no SXR. I'm 63.

 

AFAIK I have had no COVID, so Ive ruled that out (see below).

 

The problem now is that I have days when I am giddy, and cannot even walk the 3 steps at the 7-11. I'm an avid bibliophile and work in education, but can't concentrate as I used to. I use Zolpidem nocte, but it's the only wonderdrug for a deep and calm sleep (yes, I know all of the risks, but have never driven to get a burger while stark naked)---I have no intention of giving those up.

 

Another important detail may be that my father is 90 and has bad Alzheimer's, so bad that he can wander off and we call the police to find him.

 

I am not a neurologist, but my guess would be a Scan soon. I have Platinum Aetna. I live close to Paolo at S.Kwai, but I use Samitevej for complex stuff.

 

This sounds to me like post-concussion presenile dementia, especially because of the family trait. I don't know enough to rule out Parkinson's, but it may be too early to shuffle and pill-roll.

 

Can anyone recommend a very good neuro person?

 

Eddy

[Sheryl]

It could be anything, including non-neuro cause like a cardiac arrythmia, or an inner ear problem. But it could also be post-concussion syndrome though this would usually appear within a few moths of the concussion, not 6 months later.

 

You can start with a neurologist but might need referral elsewhere if no neuro cause found.

 

At Samitivej I would suggest  https://www.samitivejhospitals.com/en/doctors/chottiwut-tansirisithikul/?initial=all&hospital=1&gender=all&lang=all&schedule=&special_clinical=&specialty=spc_5&keyword=&checkformSearch=1

 

[pauleddy]

Thanks Cheryl

 

Im already under Prof Suphot (Cu) for cardio stent but I haven't had a 24-hour tape for years. I still don't think it's cardio.

 

I did get (and sometimes still get) the horrible labyrinthitis bouts which also , I think, happen in Meniere's.

 

The main worry is this strange mental deterioration. I also had a long-lasting diarrhoea that was unresponsive to Cipro at the start of the pandemic, but nothing bronchial or anything else (Cipro always works for me, so Im guessing viral). Now we read that people have all sorts of post-acute effects for months, including mental/psych.

 

The neuro guy looks good. I know that they have 2 or 3 neuros at Paolo--do you know anything about them as it's much closer? I don't know whether you agree, but Samitevej is first division (but I have insurance to the max). Does this guy come fom personal refs? Where should I start? I agree that it could be anything of a dozen things. Do you know whether PSD or Alzheimer's is familial?

 

Thx Again

 

Eddy

[Sheryl]

The recommendation is based on qualifications, not any direct or second hand experience.

 

i cannot say anything about the neurologists at Paolo as their website gives no information on doctors backgrounds etc.

 

Early onset Alzheomers (i.e. striking before age 50) is familial but not regular Alzheimers and there is negligible familial aspect to Parkinsons.

 

As you now mention labyrinthitis I think inner ea cause would be the first thing to explore re the giddiness, and that needs a different specialist. TYou could rteturn to whomever has treated yo ui nthe past for this or else this doctor is absolutley top notch:

 

https://www.bumrungrad.com/en/doctors/Saowaros-Patarapak

 

And as you are most concerned regarding the mental deteroriation, a neuro specializing in that would be best and I can strongly recommend:

 

https://www.bumrungrad.com/en/doctors/Ketchai-Suavansri

 

Both as you can see are at Bumrungrad. Costs similiar to Samitivej.

 

I know you don't want to hear this, but the Zolpidem may well be if not the cause then at least making this worse and would certainly not be advisable if you were in early stages of dementia.  That it caused no problems before does not mean it isn't now; as we age, our susceptibility ot adverse effects of medications greatly increases.

 

Personally, before investing in seeing these specialists, I would first try a week off the Zolpidem (and any other sleep meds other than perhaps melatonin) and see if that makes a difference.