Question: My 47-year-old son has been diagnosed as manic/depressive with schizoid disorder for many years. He has recently been in ICU for two months with pneumonia and liver problems and then in a nursing home for over a month learning to walk. Since his last manic episode, he can't remember anything that happened less than 15 years ago. He can't even remember something that happened 15 minutes ago. He has been diagnosed with alcohol dementia, but I don’t accept that since he could remember before going into the hospital. He is on Resperdal and Cymbalta as well as many non-psychotic drugs. He has only been back on his anti-psychotic drugs a couple of weeks. Is there hope?


Dr. Hibberd's Answer:

You should never lose hope. Our body and even our brain can recover from what seem like insurmountable challenges with disease and injury. Sad to say, many people are not aware that heavy drinking can be very toxic to brain, spinal cord and liver tissue. Unfortunately alcoholic patients often eventually suffer encephalopathy (brain disordered function) and alcoholic dementia that is usually related to protracted nutritional deficiencies in thiamine, B12, folate, and the B vitamins. Wernicke's encephalopathy is usually reversible, but ill effects from Korsakoff's psychosis or possibly even toxic alcoholic encephalopathy, may remain for a lifetime. Hopefully his gait disorder can be improved. All these conditions will adversely affect gait and balance, and nutritional deficiencies can also cause alcoholics to lose their sense of balance. (Cerebral strokes and hemorrhages are more common in alcoholics, and recovery is not always as complete.)

I consider these conditions to be the equivalent of toxic strokes, and intensive rehab and skilled management are essential to maximize recovery and minimize further loss. Add a mixture of psychiatric drugs, and the disaster you have experienced can be the result. Severe infections of the body, such as your son’s ICU pneumonia and his alcoholic hepatitis or possible liver failure, will also adversely effect brain function and memory. Hopefully he can recover, but since he appears to have such severe problems, brain imaging would be worthwhile to be sure he has no subdural hematoma (blood clot) or other correctable condition. Any estimate of recovery is premature without a detailed assessment of his current condition, lab indices, nutritional assessments and MRI/CTT image reports.