[breezeTrowel]

A bit of a shot in the dark but I wonder if Lee Holloway had (has?) a latent vitamin B12 deficiency? Serum tests for B12 deficiency are notoriously unreliable so it may not have been detected unless other tests were performed.

Vitamin B12 deficiency can disrupt sleep patterns, can cause symptoms consistent with FTD (including brain atrophy), and the use of nitrous oxide in general anesthesia on someone suffering from B12 deficiency can result in devastating neurological effects.

Like I said, it's definitely a shot in the dark but it's definitely something to think about.

[atdrummond]

Unlikely. This kind of brain injury and dementia isn’t uncommon in heart surgery patients. It’s a known risk. We aren’t 100% certain of mechanisms of action.

[breezeTrowel]

But his cardiac surgery was in 2015.

Meanwhile, according to the article, symptoms began to appear far earlier. There is mention of migraines in 2009 and 2011 appears to be the start of some sort of sleep disorder (him sleeping for three days is used as an example) as well as the beginning of marked personality changes.

All this was already underway before the 2015 surgery - the surgery seemed to accelerate the deterioration but does not appear to be the trigger.

EDIT: Came across this paper while browsing PubMed:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837928/

Here's an interesting quote:

"Additionally, infants and children with congenital heart defects often show disorders in folate metabolism (low folate, higher homocysteine, or low vitamin B12)."

Considering the surgery was to repair a leaky aortic valve which he's had since birth, it just seems like another data point.

Just my two cents.