My mom's episode today

Worried child

My original post is here, with background information

https://alzconnected.org/discussion/64342/this-is-my-intro-long#latest

TL;DR, white female, 84 years old, 5-2, about 110 lbs, history of late onset epilepsy, Diagnosed with dementia three years ago on the basis of a psychotic episode, brain scans and a brief interview with a neurologist (covid hit and brought everything to a halt). Mostly asymptomatic until last summer when she began having intermittent episodes of confusion. Taking Citalopram, Keppra, Seroquel, very low dose of Ativan for sleep at night and as needed during the day, as well as statin and blood pressure med.

Me, her son.

Did really well this week. Cooked yesterday, which she hadn't done in a while and it turned out fine. Today, she was sort of...manic, I guess. Racing thoughts, rambling speech. A baseball game was on television and she thought her grandson was playing. When she's in one of these states she often thinks she sees someone she knows on television.. I reminded her that he played baseball in high school but he's in college now and isn't playing any more. She agreed with me this is true. She didn't recognize the food she was eating. "This fish tastes strange." It was ham. (A little later she did recognize what she was eating). She felt an urgent need to call her brother, but couldn't explain why.

At the same time, she knew what day it is, that Easter is this Sunday, that her grandson is coming home from college for the holiday. She remembered without prompting that she spoke with my sister on the phone a few days ago and some of the things they talked about.

She agreed to take an Ativan. After a while she lay down for a nap. She woke up in late afternoon thinking it was morning, with very little if any recollection of the day up to that point. She was much more like her normal self, although still slightly confused.

This is a fairly typical episode. Some are worse, some are not as bad. Sometimes she has hallucinations. One time she didn't recognize family members, although that's only happened once. Sometimes she just seems a little more hyper than usual. She may go weeks at a time with nothing out of the ordinary, then have several days when things are up and down.

I should add these recent episodes don't seem to distress her, although they certainly distress us. If anything, she's rather cheerful. Of course that could change, and it's something else I worry about..

I guess what I'm asking is, what does this sound like to you? Maybe partial seizures? I'm thinking we may need to revisit this with a neurologist, although her internist thinks it may do more harm than good since it would involve a long trip and possible stay in the hospital (we live in a fairly remote area). Thanks in advance for any comments!

Dekneese

W

M1

Hi WC. Makes me wonder about Lewy Body dementia--the intermittent nature with the hallucinations particularly can be hallmarks. Don't know that it would change much (from a practical standpoint) to have a definitive diagnosis, but it might give you clarity. Doesn't sound like seizures to me but if she would tolerate it, a neurologist could do an EEG I guess.

Anjali Sunita

Hi WC

The difficulty knowing day, time, season. The variability of the disease on an hourly, daily, sometimes weekly or longer basis. Anxiety/urgency … even potentially mild psychosis. Not recognizing family members. I’m not a doc but nothing in here sounded unfamiliar when my mom was in an unstable blood pressure/ uncontrolled anxiety state and my mom just has straight Alzheimer’s diagnosis.

I think my mom was also on the brink of psychosis last year. Hallucinations were mild like seeing forms in shadows. I had been abroad for 3 years and my brother had her half of the time and when I came home she was in quite a state. For whatever it’s worth, I noticed a marked difference when we got her blood pressure under control again which was extremely variable along with an anti anxiety prescription along with family living with her, nutrition (she was not well nourished at the time) and lots of changes short term that to me all added up to reducing the anxiety.

I don’t know if this helps or is your circumstance.

Maybe there’s still docs out there willing to at least initially consult virtually who can give more insight given your moms health history & current medications, that would be less disruptive initially than a long trip.