Expert: Claes-Gustaf Nordquist, M.D. - 4/3/2008

Question
Dear Dr. Nordquist,
   A number of years ago I began having severe depersonalization symptoms that greatly impaired my ability to function in school. At that time (2005) I had a battery of tests that included two MRIs which indicated an anomoly with my basal vein of Rosenthal but nothing more. I was prescribed Paxil and the dissociation went away. My father recently passed away and although I was initial fine, I experienced something akin to a panic attack which has left the residual symptoms of nausea, fogginess and depersonalization/dissociation. I am now taking Clonazapam to combat these symptoms and it is helping a bit. Perhaps it's just paranoia, but I have begun thinking that it's possible I have some sort of structural or organic brain problem (tumor, lesion etc.) Then I think that my MRI would surely have indicated such if anything had been present. Can you advise me on what to do? I am seeing a therapist but should I get medical help? Another MRI or CT scan? See a neurologist? Thanks for any information you could provide-Natasha

Answer
This sounds more like a psychological/psychiatric problem to me not a medical. However your problems will probably not go away just because I tell you that, so I suggest that you let a neurologist check you again. An MRI scan again would be able to exclude any suspicion of a brain tumor.