Discussion:
"cerebral encephalitis" residual effects
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JR
16 years ago
Permalink
Have a cousin who had "cerebral encephalitis" as an infant.

Had to learn to walk a second time; problems with spatial abilities, motor
skills,conduct problems as a kid.

Are there any patterns/locations of damage that typically occur in such
cases?

How valid is Daniel Amen's techniques and would the be useful in such a
case?

Can neuropsychologists really determine the location of brain damage?

Do drugs really offer any solution in these cases?

Any answers? Thanks.
John Hasenkam
16 years ago
Permalink
Residual effects should be expected but it is impossible to know the extent
and nature of these effects. Even chemotherapy in childhood can have long
lasting effects on brain function and behavior. Your cousin has experienced
two distinct kinds of brain trauma: one from the infection and a milder form
arising from the immune response to that infection. He may well be
sensitised to psychological stress and so be more prone to depression and
behavior issues arising from stressful events. He may also experience sleep
problems and have to put in much more effort to sustain concentration, with
subsequent tiring much earlier than other people.

You could go looking for sites of damage and probably find something.
However the value of this is problematic and the damage may well be diffuse
and difficult to establish. That is, to clearly establish evidence of brain
damage could require some rather esoteric imaging technologies and even if
the same is established it won't necessarily bring forth any therapeutic
possibilities. For eg. the Amen Clinics site mentions SPECT imaging.

Drugs? What drugs? Yes, there may be some value but it really depends on the
types of drugs and the targets for those drugs.

There may be some nutritional and behavior interventions that can help but
you'll need to find a damned good clinician who is prepared to put in a lot
of work. Of course that means dollars, time, and commitment.

A quick look at the Amen Clinics site at least suggests he knows what he is
on about but the title of one of his publications: "magnificient mind at any
age" is ringing alarm bells in my head. Too much hyperbole. The website also
offers a number of products they are selling with fancy names and mediocre
contents. For example, want to boost omega 3s? Oh I don't know, you could
buy those fancy pills or eat more Atlantic or Tasmanian salmon. "Neuro St.
Wort" as a product. Oh please ... . St. John's Wort is a regular and proven
treatment for mild to moderate depression, very widely used in Europe.

Neurolink:

Vitamin B6. Or you could eat more leafy greens.
L-tyrosine: essential amino acid for dopamine and nore creation. Not a bad
idea but could be problematic with dopamine agonists or SNRIs(?). Brain
injury can lead to a chronically lowered "dopamine tone" so L-tyrosine may
help to address this; if it exists in your cousin(lethargy, easily tired,
poor attentional skills).
GABA: inhibitory neurotransmitter, a nice settling effect but how much
sedation do you want in a developing brain?
Inositol: Vitamin B group: eat more greens.
Taurine: Good idea.
5HTP: serotonin. Whoopee.

---

Let me guess what will happen here. You go to the clinic, the doctor,
probably with the best of intentions, will advise this supplements and that
supplement ... . I also suspect he has a MRI machine so will want to use
that as often as possible. The acid test for these "revolutionary
approaches" cannot be established by those promoting these approaches. You
need to find independent appraisals of what Amen is offering. You don't
determine the value of a product by the claims of the seller, a lesson too
many people forget when addressing medical issues.

Who? Me? Cynical? Always be cynical of celebrity doctors.

What can you do?

Maximise the child's overall health, particularly nutrition wise. Long list
here.
Address specific behavior issues with a good therapist, which can be hard to
find.
Consider stress management programs.

----

I could run off a list of supplements that might help but I've got nothing
to sell. You might be able to find good therapists through your regular
doctor or a brain injury organisation.

---

Yes, drugs can be very useful but it can take quite a bit of experimentation
to find the right drugs and doses.

John.
--
http://healthycuriousity.blogspot.com/
Post by JR
Have a cousin who had "cerebral encephalitis" as an infant.
Had to learn to walk a second time; problems with spatial abilities, motor
skills,conduct problems as a kid.
Are there any patterns/locations of damage that typically occur in such
cases?
How valid is Daniel Amen's techniques and would the be useful in such a
case?
Can neuropsychologists really determine the location of brain damage?
Do drugs really offer any solution in these cases?
Any answers? Thanks.
JR
16 years ago
Permalink
Thanks much for your detailed reply. I reached pretty much the same
conclusions re Amen clinics, and treatment options as you have astutely
stated in your reply. Which of the supplements you know of are least
likely to have negative side-effects (other than depleting one's
wallet). You said taurine was a "good idea", any particular reason that
stands above the other you mentioned? Amen also recommends
DL-phenylanine (sp?). A drug we have tried so far that is often
recommended and seemed to help, but had side effects was desipramine.
...
John Hasenkam
16 years ago
Permalink
--
http://healthycuriousity.blogspot.com/
...
1. Taurine

I had a look at this sometime ago but my knowledge is sketchy. It is an
amino acid which has proven beneficial in preserving neurons, particularly
retinal neurons. Apparently it helps in the production of GABA so it might
have a slightly calming effect but the evidence for this is very weak. More
importantly, as your cousin appears to have depression issues, and sustained
depression can lead to neuron death, maintaining taurine levels is a good
idea. This is particularly important in people who have experienced any type
of brain trauma because there is evidence to suggest these events can
initiate subtle and longstanding processes that are damaging to the CNS. For
example, even mild brain trauma in childhood can increase the risk for
dementia in adulthood. Taurine is an amino acid, you could look for
supplements or you could look for natural food sources of the same. I'd opt
for the latter option.

PS: in the context of that supplement, the addition of taurine is a good
idea because if taurine levels are low the other elements cannot do their
job.

2. DL phenylalanine:

Amino acid precursor for nore and dopamine synthesis. Not sure taking this
with desipramine is a good idea as both can act as nore agonists.

3. Desipramine

Antidepressant tricyclic boosting nore, reuptake inhibitor. Lots of
potential side effects. MUST never be taken if consuming alcohol. As a
general word of warning: be very careful in using "natural products" in
conjunction with psychiatric drugs. While natural products, when used
judiciously, can confer great benefits, these can also carry risks. For
example, SAMe is often touted as a natural antidepressant. Yet is can also
induce mania in susceptible individuals and because it is a potent methyl
donor long term use will increase the risk of cancer and hyper homocystemia;
the latter being associated with dementia, heart disease, and generally
perceived as a marker for metabolic dysfunction. Ever hear about that cancer
risk? No, the sellers will never tell you that.

4. Strategy

The vast majority of capable clinicians are busy making their money and
helping their patients. They are not interested in promoting whiz bang ideas
or playing the spin doctor game. Your challenge is to find one of those
capable clinicians. It is easy to sound like one has a deep and profound
understanding of how all these agents work in the brain. A few techno words
here and there, some fancy technology, and the average Joe or Jane can
easily be beguiled into thinking that the clinician is in possession of some
secret that is unknown to the wider clinical community. I know, I can play
that game with ease.

The truth is that a great deal of the time it is an educated guessing game.
You need to be prepared to spend a lot of time and energy to help your
cousin. So does the clinician. It can take quite some experimentation to
find the correct drugs, dosages and other therapies that work for each
patient. In the meantime:

A healthy body is a healthy brain. Maximises the child's health through good
diet, regular exercise, and if he\she lives in northern climes watch the
vitamin D status. There are even studies indicating that children with
behavioral issues who spend time in the outdoors and sun can have
significant improvements. No need for lots of pills and potions, a good diet
is easy to achieve but keep in mind the following:

Avoid sugar spikes in food. High fructose corn syrup should be labelled with
a skull and cross bones.
Avoid additives. Many studies now indicate that a number of food additives
can affect behavior.
Make sure there is a good serving of omega 3's in the diet. x3 per week.
Must be long chain omega 3's as in oily fish.
Depending on age, serious consideration(in my view mandatory) should be
given to teaching stress management techniques.
A full neuropsych workup is worth considering, in this case I'd rate that as
more valuable than imaging technologies.
Behavioral therapies are time consuming but over the long term can produce
enormous benefits.
Be advised that there are many options for treating depression. If the
current strategy is solely drug based, consider changing that or the
clinician.

----

Please be advised I am not a clinician, just a crazy Aussie tucked away in a
beautiful little valley who spends his days thinking too much and doing too
little.

Best of luck, after lots of hard work ... .

John.
...
JR
16 years ago
Permalink
"John Hasenkam" <***@goawayplease.com> wrote in news:***@westnet.com.au:
"John Hasenkam" <***@goawayplease.com> wrote in news:***@westnet.com.au:
You may not be a physician, but I can tell you know what you're talking
about.

Yes, I am aware of the interactions between tricyclic and other A.D.'s
and supplements.

The problem, as you an eluded to, is that we know very little still
about how the brain works; as you have said it is easy to throw around
2-bit words and make it sound like we DO know, when,in fact, we don't.

One thing that worries me with amino acids is that *I think* nature
intended us to take them in balance, so supplementing with one at higher
doses may have more effects than one is aiming for. So, your idea of
natural sources seems logical to me.

The other point that is worth mentioning is that most of these
psychotropic drugs have only been tested in short term clinical trials,
usually a couple months at most. This does little to show any potention
long term negative side-effects on the brain for the longer periods they
are prescribed-often years.

Also, although I believe we have a reputable supplement supplier, there
really is not proof that what we buy over the counter is accurately
labeled, another argument for natural sources. And I agree absolutely
that corn syrup should be banned-a terrible ubiquitous additive that is
hard to avoid.

I will give Taurine a try though, based on your recommendation. He is
currently off the desipramine. Also, will freshly ground flax oil be a
adequate substitute for fish oil, do you think? I think I will also
advise a small vitamin D supplement.

Also your comments on SAM-e are well taken. I previously searched the
forums on this and found a ton of negative posts from many different
individuals who became very sick taking Sam-e. It is interesting that I
find the internet to be a good source of information that often
contradicts the "official" (drug rep, medical industry) information on
these various chemicals.

Thanks so much for your good replies.
John Hasenkam
16 years ago
Permalink
--
http://healthycuriousity.blogspot.com/
...
You hit the nail on the head. Balance of nutrient intake is very much
neglected. A classic example is magnesium and calcium. There is this huge
fuss about maintaining calcium levels but it is very important to maintain a
balance between these nutrients. Recent studies point to widespread
magnesium deficiency. It is the one supplement I take on a regular basis but
I do so because I am inclined to get cramps and magnesium is very useful for
me in combatting this. Other than that I pop a a multi twice a week and good
quality alpha lipoic acid. Stress may induce magnesium depletion. Magnesium
plays a role on preventing excessive nervous activity, hence the old
sleeping remedy: Milk of Magnesium. A recent study indicated that magnesium
+ some vits could play a vital role in preventing age related hearing
decline. Some nuts are good sources of magnesium. Magnesium supplements are
very cheap, check his diet and then give thought to providing magnesium. If
the child has trouble sleeping, try a magnesium intake prior to bedtime, see
if that helps. As the child is probably stressed there may be a magnesium
issue.
...
Too many studies have found that over the counter supplements are of
atrocious quality. It is very difficult to find a good supplier. Here in
Australia the Therapeutic Goods Administration is currently preparing
guidelines so that consumers can have a better idea of the quality of
supplements. A friend of mine in New York recommends the Vitamin Shoppe.
Again, you need to find independent analyses of the products.
Post by JR
I will give Taurine a try though, based on your recommendation. He is
currently off the desipramine. Also, will freshly ground flax oil be a
adequate substitute for fish oil, do you think? I think I will also
advise a small vitamin D supplement.
Yeah, taurine is worth a shot.

Recent studies on vitamin D indicate that RDAs are woefully inadequate. A
small mountain of studies now indicate that maintaining vitamin D status is
vital in relation to autoimmune conditions, dementia prevention, heart
disease, and some argue that vitamin D is the single most important nutrient
in cancer prevention. A US cardiologist has some excellent advice on vitamin
D:

http://heartscanblog.blogspot.com/

Scroll down the post list to see the relevant articles.

Important points:

Like most fat soluble nutrients, absorption is contingent on there being fat
present in the gut. So take your vitamin D, should be D3(?), certainly not
D2, with some fat containing foods.
Tablets must be oil based.

PS: I disagree with him re vitamin D production through sunlight declining
with age, I think he is overstating the case.


Flaxseed:

Contains the short chain omega 3. The usual recommendation is that because
the human brain only very slowly converts these to long chain fatty acids,
more fish should be in the diet. I've always had problems with this but that
analysis is long and complicated. Flaxseed meal also contains lignans that
have anti-cancer properties. However there is data indicated that
consistently high intake of short chain omega 3's can be a risk factor for
prostate cancer. Don't know how to quantify this risk or even if it is a
real risk. To be safe, probably better to aim at fish but here is an example
of how tricky that becomes. I read one study recently which found that fish
consumption was conferring benefit but not if the fish was fried. What most
people do not appreciate is that frying fatty acids, particularly omega 3s
which are very easily oxidised, can destroy the benefits of these fats and
create trans fatty acids. The fish is dead but you don't have to cremate it!
It may well be the case that our propensity for high temperature cooking is
robbing nutrients from our foods.
Post by JR
Also your comments on SAM-e are well taken. I previously searched the
forums on this and found a ton of negative posts from many different
individuals who became very sick taking Sam-e. It is interesting that I
find the internet to be a good source of information that often
contradicts the "official" (drug rep, medical industry) information on
these various chemicals.
Read the Heart Scan blog, he is scathing of "official advice", drug
companies, and in some instances the medical industry.
Post by JR
Thanks so much for your good replies.
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