Help me figure out what's causing these cognitive & autonomic symptoms

[Zebra]

ChatGPT suggested for example: autoimmune encephalitis (e.g., anti-NMDA receptor encephalitis, limbic encephalitis, Hashimoto’s encephalopathy).

So, AI backed up the Human Intelligence I shared in several posts on this thread. : )

 

[SpinachHands]

Have you tried placing these symptoms into various AI bots? These can provide useful potential diagnoses.

I just asked some AI bots the following question:

Spoiler: Question to AI

What could be the cause of the following list of symptoms, given that many of the medical tests and scans listed below found nothing remarkable:

Symptoms list:
- severe cognitive issues: difficulty thinking, concentrating, short term memory problems, every day this is getting worse (at the start of this year they old listen to audio books, now they can barely keep up with a five minute YouTube video, will often repeat the same question not recalling if they asked or what the answer was, can't remember what happened in the day by the evening)
- the above can have worse episodes of disorientation, confusion, not being able to answer or comprehend simple questions, can act "out of it" or like drunk/high, can become giddy/delirious
- intense feelings of pressure in the head, as though something is expanding in their head, generally felt all over, sometimes also in front with sinus pressure
- worsening blurry vision and double vision
- severe dizziness
- mood changes: uncharacteristic/unprompted anger, aggression, rage
- constant whole body feeling of "fizzing" or "sparkling" similar to pins and needles
- sudden weakness (distinct from fatigue, not related to energy but more an inability to move, sometimes becoming full paralysis, particularly in legs)


Tests and scans list:
- all blood tests and panels for infection, inflammation, nutrition/vitamin deficiency, full blood counts, have come back clear, the only exceptions being a low white cell count, and a high ALP
- recently redone thyroid/hormone testing, all normal
- awaiting results of some more specific blood tests, and some 24hr urine collection tests
- head CT, head MRI with and without contrast, spine MRI without contrast, all clear
- eye check for papilledema all clear
- EEG clear
- ECG clear
- home blood pressure tests suggest frequent low diastolic blood pressure particularly, with occasional large sudden increases in BP
- abdominal ultrasound (investigating high ALP) clear

ChatGPT suggested for example: autoimmune encephalitis (e.g., anti-NMDA receptor encephalitis, limbic encephalitis, Hashimoto’s encephalopathy). Plus it gave many other suggestions. You might like to post the same question into ChatGPT, and read the full set of answers it gave.

I would try asking the same question to the following AI bots:
https://chatgpt.com/
https://www.perplexity.ai/
https://gemini.google.com/
https://grok.com/

You can also try entering the symptoms one by one, separated by commas, into https://www.symptoma.com/ , which is an established dedicated medical AI diagnostic too.

Thanks, we've done blood tests for autoimmune encephalitis as that was one of my first thoughts, but negative and no signs of it on the MRI. The NHS neurologist has still agreed to do a lumbar puncture as well thankfully (although this guy is still very insistent he thinks it's FND, so if the lumbar puncture is clear we won't waste more time with him)

 

[SpinachHands]

I've got gotten back results from my partner's hospital stay, and there were some concerning results in there that weren't communicated to us at the time.

Firstly, their blood gas results showed massively low oxygen, normal CO2, and that 20% of their red blood cells weren't carrying oxygen (it's normally meant to be 4-6% of them). I have read that since it's more of a snapshot view things like holding your breath can affect results, but that would increase your CO2 at the same time.

Secondly we were told that their white cell count and lymphocytes were low on admission but went back to normal, when actually they remained low, alongside a low RBC.

Their clotting time was also too high, alongside several other immune markers that were on the low end.

Finally, although we were told their brain MRI was fine, the radiology report says:
"prominence of the central canal of the distal thoracic spinal cord, postcontrast sequences are suggested to exclude an underlying lesion." Apparently this is an issue that can read to a reduction in blood flow to the brain, the exact thing suspected by the private specialist.

I've sent copies of all this to her, the neurosurgeon we saw, and an autonomic cardiologist we're following up with next month. Have also chased to GP to explain why this wasn't considered significant, and to reiterate the need to refer to immunology.

 

[sb4]

good work chasing all that up.

 

[Zebra]

"prominence of the central canal of the distal thoracic spinal cord, postcontrast sequences are suggested to exclude an underlying lesion."

If I had a potential "lesion" on my thoracic spinal cord, I would be keen to follow up with an MRI with contrast, as the radiology report suggests.

It's a shame that your partner's medical team didn't get a second thoracic spine MRI with contrast while your partner was in hospital.

As this possible "lesion" is located at "the distal thoracic spinal cord" I'm wondering if your partner also received an MRI of the lumbar spine?

 

[SpinachHands]

If I had a potential "lesion" on my thoracic spinal cord, I would be keen to follow up with an MRI with contrast, as the radiology report suggests.

It's a shame that your partner's medical team didn't get a second thoracic spine MRI with contrast while your partner was in hospital.

As this possible "lesion" is located at "the distal thoracic spinal cord" I'm wondering if your partner also received an MRI of the lumbar spine?

I asked the GP why these comments on the MRI weren't mentioned to us, they got the neurologist to call me who said it "wouldn't cause any of my partner's symptoms so didn't think it needed further investigation". I listed the top symptoms that came up when I looked this up, which my partner has, and said "so it wouldn't cause any of these?" And he said no. So, either my research is wrong or he's lying. Either way I've also sent it to a private neurosurgeon we saw to see what he thinks.

As for "medical team" it was more just several disinterested neurologists who acted like we were wasting their time.

They did have a full spine MRI without contrast that didn't show any issues apparently, but maybe the comment means they think a spinal MRI with contrast is needed.

 

[Zebra]

but maybe the comment means they think a spinal MRI with contrast is needed.

Agree! The radiologist's comment means that a thoracic spine MRI with contrast is needed to better evaluate the possible lesion, which could be anything.

I'm so glad you got a hold of your partner's complete hospital records.

It's amazing what bald face lies doctor's will tell us to our faces.