Expert: Claes-Gustaf Nordquist, M.D. - 12/30/2010

Question
QUESTION: my father was detected with a tumor which was operated on 5th of may 2009.  the tumor was detected as anaplastic meingioma.  

Post operation he had weakness in his right hand and was not able to ooperate it fully.  though he was managing all his activities independently.

He had also gone through the radiotheraphy of 30 sittings and 5 days of oral chemotheraphy

Until july 2010 everything was perfectly alright.  He had done MRI trice and all the time there was no recurrence of the tumor.

On july 31st he had seizure/cunvulsion and was hospitalised.  though he was discharged after 10 days but his right hand and now right leg became very weak.  He is able to llimp and walk with a support of a stick and hand is very very weak.  His speach has also slowed down.
when MRI was taken there no recurrence of tumor but there was edima on post radiotherphy area. docs said that the convulsion/seizure was due to this and will recpover over period of time.

He is taking eptoin 1-0-2 and levipil 500 1-0-2.

his intake of food,liquid, stool, urine, his cbc levels everything is normal

he is undergoing phsyotheraphy everyday and doing regular exercise,  he is able to stand and walk very slowly for few steps but is not able to balance himself. he has fallen down few times

what is the solution for this?  how long will it take for him to regain his walk?  

can u pls help me?

regds
K V balaji
9978996245

ANSWER: If his problems are ONLY caused by his radiation induced brain edema it may get better over time but how far and how fast is impossible to determine in advance. If on the other hand it has to to with any more extensive neurological damage or that his tumour in fact is coming back though not yet detected I must be more pessimistic. At present it is probably impossible to determine which one of these that is the truth.




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---------- FOLLOW-UP ----------

QUESTION: dear doc,

regarding your comment on"If on the other hand it has to with any more extensive neurological damage or that his tumour in fact is coming back though not yet detected"

what is the way to find out?  the last MRI was done on 1st week of august and there no recuurence of any tumour and the report was shown to a neurophysician who examined all and said thast the same is post radiotheraphy only.

What is the other way to know if there are any othere neurological damange since post operation (may 2009) till july 2010 he was very active and was fully mobile.

Answer
The only avilable methods are CT scans without and with contrast and MRI scans (best) without and with contrast. Information can also be gained by PET scans (scans with radioactive isotopes). Scans must be repeated over time since the situation may change. Older X-ray techniques like angiography are also available but can hardly compete with MRI. I wrote that it may be impossible at present to be sure and that is still my opinion.


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