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Neurology (Expert Forum)
Meningioma post-op oddness
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Meningioma post-op oddness
by saoirse1, Jun 02, 2005 12:00AM
I am 47yr old F. I had a craniotomy on 5/12/05 . This to remove a meningioma, right frontal convexity, about 3cm. Had no symptoms till 4/20/05, when I lost feeling entirely in almost entire left side. Called 911, rushed to Presbyterian Hosp. here in Charlotte. A stroke was suspected but ruled out. MRI found this thing. Saw Neurosurgeon 5/4/05. Was placed on dilantin 300 mg and the dreaded decadron to be taken for 3 days prior to surgery. Weaned off steroid before release from hospital 5/16. Dilantin raised to 400 mg because level discovered to be at 8. Pathology found tumor benign, post-op MRI showed tumor a goner. Am very grateful for both these bits of good news.
Discovered after surgery , profound weakness in my left arm. Have been working hard with in-home therapist to regain use; this has been very successful so far.
Once in hospital, and several time since, have had what I am being told are "sensory events/phenomena". Periods of numbness that briefly strike various portions of left side .
Reported more about this at F/U with NS 5/23/05. Doc explained that the tumor sat directly between sensory and motor function areas for left side. That my brain is quite irritated from surgery. These events are what he believes to be a part of the recovery process. Assured me these events would not impede the physical progress I've made thus far, which was a big worry. Expects they will dissipate. Dilantin level that day, btw, was at 16 and they were pleased with that. I have also had tingling/pins & needles in both hands. Legs feel "
Discovered after surgery , profound weakness in my left arm. Have been working hard with in-home therapist to regain use; this has been very successful so far.
Once in hospital, and several time since, have had what I am being told are "sensory events/phenomena". Periods of numbness that briefly strike various portions of left side .
Reported more about this at F/U with NS 5/23/05. Doc explained that the tumor sat directly between sensory and motor function areas for left side. That my brain is quite irritated from surgery. These events are what he believes to be a part of the recovery process. Assured me these events would not impede the physical progress I've made thus far, which was a big worry. Expects they will dissipate. Dilantin level that day, btw, was at 16 and they were pleased with that. I have also had tingling/pins & needles in both hands. Legs feel "
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jun 04, 2005 12:00AM
It sounds like you did have seizures arising from the area of the tumor that involved sensory symptoms on the left side (the right side of the brain controls the left side of the body_
The specific area that the seizures come from is not within the tumor itself, but from irritated brain around the tumor (in the immediate vicinity). Most of the time, with complete resection, this area is removed also. But ther is a chance that some irritated brain remains. Also, the irritation from surgery in this area can increase the risk of postop seizures, but this effect is usually only in the first week or two. Whether seizures will continue or not it is too early to tell, and time will tell over thenext few weeks. In they do, there are other antiseizure medications that may be more effective than dilantin such as carbazepine or leviteracetam.
Pins and needles that occur bilaterally are usually not due to seizures and may be from another cause ie electrolyte disturbances, hyperventilation, peripheral neuropathy, pinched nerves like carpal tunnel etc. If this persists you should talk to your neurologist about it.
although the seizures seem brief and sensory only, there is a chance that they could spread to involve other areas including loss of consciousness (although less likely on medication). So do not miss your medication, or stop it suddenly. Be careful in anysituation where having a seizure could be dangerous like heights, operating heavy machinery, swimming. you should take showers rather than baths. If you have no furhter seizures you could consult with you neurologist about coming off anitseizure medication in 6-12 months.
Good luck
The specific area that the seizures come from is not within the tumor itself, but from irritated brain around the tumor (in the immediate vicinity). Most of the time, with complete resection, this area is removed also. But ther is a chance that some irritated brain remains. Also, the irritation from surgery in this area can increase the risk of postop seizures, but this effect is usually only in the first week or two. Whether seizures will continue or not it is too early to tell, and time will tell over thenext few weeks. In they do, there are other antiseizure medications that may be more effective than dilantin such as carbazepine or leviteracetam.
Pins and needles that occur bilaterally are usually not due to seizures and may be from another cause ie electrolyte disturbances, hyperventilation, peripheral neuropathy, pinched nerves like carpal tunnel etc. If this persists you should talk to your neurologist about it.
although the seizures seem brief and sensory only, there is a chance that they could spread to involve other areas including loss of consciousness (although less likely on medication). So do not miss your medication, or stop it suddenly. Be careful in anysituation where having a seizure could be dangerous like heights, operating heavy machinery, swimming. you should take showers rather than baths. If you have no furhter seizures you could consult with you neurologist about coming off anitseizure medication in 6-12 months.
Good luck
"heavy" about an hour after I take the dilantin, improves next day as I move about more and more.
I am trying to accept the recovery theory
Called doc with this and other questions. He is actually encouraged because now these "events" seem to be intermittent, 4 days w/o any a good sign. I am still worried. Very upsetting when these things happen.
Asked also should I see a neurologist. Am told if this all persists, changes, or worsens, would be referred at that point to a neurologist.
Any thoughts/comments greatly appreciated. Thanks very much for your time.
A little bit concern. Oh yes, I mentioned it to the podiatrist that did the surgery on my foot, and he said this was normal.