Following the placement of a shunt, he began having grand Wide-Legged Forward Bend mal seizures and was treated with an anticonvulsant, leviracetam Keppra. Three years later, when Wide-Legged Forward Bend his wife brought him for a consultation, Irving had severe cognitive slowing, difficulty speaking, apathy, daytime napping, insomnia, depression, complete sexual dysfunction, and emotional incontinence with sudden outbursts of crying for no reason pseudobulbar palsy.
He was unable to work or engage in social activities, could not organize his thoughts, stuttered when he became anxious, and had to give up skiing and bicycling. Irving's neurologist was advised to slowly discontinue his anticonvulsant medication.
Once the leviracetam was removed, his cognitive functions improved about 50%.
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The first layer of treatment, R.rosea Energy-Kare by Kare-n-Herbs, led to further improvements in cognition and apathy, but Irving could not tolerate more than one tablet in the morning because of insomnia.
Next, the emotional incontinence resolved on sertraline 50 mg/day, but he could not tolerate higher doses.