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Dr. Olson,

Thank you for volunteering your time. I have a very challenging question for you.  My 17 year old son developed a conditioned about 4 months ago that displayed symptoms primarily characterized by extreme lethargy and mild confusion. Specifically he started saying he was too tired to attend school. We dismissed this as a common cold or similar. To make a long story short each day was characterized by him waking very late then saying he was "foggy" and then sleeping most of the day. We let him miss school for about 5 days then he saw his pediatrician who believed it to be a virus. When the symptoms did not go away we eventually brought him back to his pediatrician who the second time suggested taking him to the er to rule out encephalitis. Once again he was given several tests to try to rule out tumors, etc. as the er doc put it "anything that would be an obvious catch". Fast forward another three days and his pediatrician now recommends a neurologist who within a 1/2 hr visit immediately moved to have my son admitted to the hospital for possible viral encephalitis. Again fast forward and post spinal tap, blood work, and numerous tests. Long short he started to show signs of improvement and was given a "clean bill of health." and again released. About two months later (June) he demonstrated the same symptoms of lethargy and a feeling of being "foggy". He describes it as not being unable to talk or know specific facts but instead have a hard time following directions or "spacing out". Again after about 5 days he started to improve and was ok again. Now two days ago he started again with feeling sleepy and saying he felt "foggy".  I know this is a difficult one and not the typical "fever" type of question but we are desperately looking for a possible path to move down to try to get to the bottom of this...   A few thoughts i had just from doing some research on my own are possibly Epstein Barr Virus (which I understand has a specific test and he might have picked up from his last girlfriend who he broke up with about 2 weeks prior to the initial onset of the symptoms),  desperately seeking some advice. Many thanks!


Hi, Harrison,

Sounds like you have seen a bunch of people smarter than me and they have ruled out many things and not found anything.  Other conditions such as Lyme disease come to mind, but of course this would be a very atypical presentation.  There are blood tests for this and tests for mono that are easily done.  The intermittant nature of these self described symptoms would also make me think of a cycling mental health condition.  After all this physical and emotional trauma, it would be reasonable to see a psychiatrist.  I also have had good luck sending "mystery" disease kids to Mayo Clinic to be evaluated by Phil Fischer and their rare conditions team.

Good luck, Dr. Olson


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David Olson, MD


I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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