Thanks @whalereward for reading the post.
1.limbic system, not lymbic.
sorry that was a typo..
2.encephalitis could be an important cause because of it's neutrotrophic to the area of the fysifurm gyrus.Thus, acyclovir and valacyclovic are probably just markers for a viral infection and not a cause in it self, but you said associated.
you got it wrong. Encephalitis may be the cause but i didnt find article related to it, but acyclovir(specificllay speaking carboxymethoxymethylguanine, a metabolite of acyclovir ) is the cause of Cotard delusion here..which disappears after hemodialysis..
you can check it here-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151143/
I think he might have a point here. Acyclovir needs viral Dna polymerase for activation. otherwise it stays as a prodrug.
Yes, Acyclovir does need viral nucleic acid for its activation.. but what the researchers in this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151143/ article did was-- they monitored the level of plasma aciclovir and its metabolite and correleated it with the neuropsychiatric symptoms.. and found out that after hemodialysis (low plasma level of drug) the the symptoms subsided...
another point is.. why would anyone be taking acyclovir or val or gan or ganvalcyco without any medical condition related to herpes genre of viral family? good and informative post though.
thanks... sorry i forgot it to mention in the post, the patients did develop herpes infection thats why they took aciclovir ..but the herpes infection was most probably not the one to cause the symptomps (researchers did not mentioned it here- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151143/)
Got it. Just reviwed the original article. Next time a patient comes to you with nuhilistic attitude..you have one more differential diagnosis to think about now. Thanks. :-)
Yes.. :)