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Neurology (Expert Forum)
Brain Cyst (Arachnoid)
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Brain Cyst (Arachnoid)
by headproblemz, Dec 25, 2002 12:00AM
Hello, in case you don't remember me, I posted here around 8-10 months ago questioning you if I had epilepsy, and I argued with around 10 people on the board that I didn't, then, sadly, I was proven wrong and diagnosed with epilepsy. Then I sent you posted again regarding a severe anxiety disorder that I had, due to the epilepsy. Now I have another question! I went for an open-mri (I can't go for a closed mri b/c I am to claustraphobic) and a 3cm arachnoid brain cyst directly at the base of by brain was found, actually "capping" my brain! I went to a neurologist and he didn't make much of it but he sent me to a neurosurgeon, and he said it was probably congenital and he didn't want to operate or do anything to it at the moment, as the Tegretol (400 mg twice a day) I am taking seems to be controlling my seizures and auras. Nevertheless, on the mri report, it said the arachnoid cyst is having a mass effect on my temporal lobe and my neurologist seemed unsure, but he didn't think it had to do with my epilepsy, and while I read that it usually has nothing to do with epilepsy, is there a chance that it does? Also, I was able to stop Ativan (0.5 mg twice a day) but I am still taking Paxil (20 mg once a day) and I am wondering if/when I should stop it. I read in 1% of patients Paxil actually causes seizures! But I still have a moderate amount of anxiety, and I am afraid if I stop, I will get even more anxiety, or all my anxiety will come back! Can you please give me some advice on the aforementioned questions? It would be very much appreciated. Thank you again!
Doctor's Answer
by CCF-Neuro-M.D.-JT, Dec 30, 2002 12:00AM
Glad you got the right diagnosis and appropriate treatment for your seizures. Hard to say whether or not the arachnoid cyst has a role as I have not personally reviewed your films and do not know exactly where it is on the temporal lobe. Technically, it could depending on where it is and how much compression of the temporal lobe there is. If there is a question, consider a referral to an epilepsy center for further evaluation to see if surgically draining it will help your seizures. Talk to your neurologist about your concerns as he/she has had the opportunity to examine you and see your films.
As for the paxil, there is evidence that it does lower the seizure threshold in 0.1-1% patients as you mention. But this is dose dependent and as long as you are doing well on 20mg with no quick increase in the dose or change in seizure frequency, it should be ok. If you need the paxil for your state of mind (anxiety) then you need it. Keep in mind that both emotional and physical stress can lower your seizure threshold also. Good luck.
As for the paxil, there is evidence that it does lower the seizure threshold in 0.1-1% patients as you mention. But this is dose dependent and as long as you are doing well on 20mg with no quick increase in the dose or change in seizure frequency, it should be ok. If you need the paxil for your state of mind (anxiety) then you need it. Keep in mind that both emotional and physical stress can lower your seizure threshold also. Good luck.
I am one of those people who suggested you had E. Sorry, that you were diagnosed with it after all. I was diagnosed in Oct. 2002 and still haven't come to terms. I think I am more fortunate in that I am angry about it, instead of feeling anxiety over it.
Anyway, all of that to say this... I came across a forum for E that I think would be really helpful to you. The people are down to earth and share their experiences and their feelings. Here is the link:
http://neuro-mancer.mgh.harvard.edu/cgi-bin/forumdisplay.cgi?action=topics&forum=Epilepsy&number=33&DaysPrune=
I wish you well.
I remember you Jan, all too well, LOL! I'm kidding! Thanks for the information, I visited the website you posted, it's very good :o)
I am a brain tumor survivor of 12 years, a cancer survivor of 5 years and have had to face the fact there may be another brain tumor and this time there's have no medical insurance and no financial means to seek "free" medical attention, so I know a little about stress. We have choices every day what clothes we wish to wear for that day. Some of our clothes we feel very comfortable in and because of that we choose to wear them more often and for those clothes that aren't as comfortable on us, we wear as a "last choice". In either case, it is "we" who always make the choice of what clothes - whether the comfortable ones or the more uncomfortable ones, we wear for the day. The same is true for our choice of thoughts. We can choose whether to sustain an anxiety thoughtform or not - I know, for the last 12 years have been a proving ground for me. WE CAN CHOOSE to limit our time of anxiety thoughtforms. We can also choose to eventually not entertain them at all within our daily thoughts. Our problem, however, is that we have allowed our negative anxiety thoughtforms to become our "comfortable clothes" for the day. And, therein, my friend lies the rub!
My days may be numbered now but I shall not indulge in a sustained anxiety ridden thoughtform-type of life. If I, a dyed-in-the-wool, full-fledged queen of the "victim thoughtforms", can kick the anxiety thoughtform habit, so can anyone. It's a matter of our daily, actually it's our minute-by-minute, thoughtform choices. Our anxiety can be managed by our own desire to live a different way. If you feel from your heart that you've had enough of this anxiety stuff, please consider altering your thoughts - minute-by-minute. Habits are formed within 3 days time and they're done minute-by-minute.
Please know that whatever thought choices you make, that I honor your life and how you choose to experience it in order to know yourself in that way.
AnMaRa