Brain Cyst

[mayan1021]

Hello Im currently 22 yrs old. I have had a cyst in  my frontal lobe since I was 5 yrs old. The doctors mentioned that the cyst was dead due to excess of calcium. At age 5 I had a seizure but nothing was done about it. At  age 13 I had two more seizures and thats when doctors put me on Tegretol 200mg. An MRI was taken at age 5 and at age 13, the size of the cyst remained the same. The seizures only occur while I am asleep. As of now the Tegretol has worked but pretty soon I wont have insurance to cover the medicine. Previously like a few weeks ago I took Tegretol 2x day (morning and night). I talked to my neurologist about this and she recommended I have an EEG (which came out to be normal). So she told me to take Tegretol once a day. As of now I feel fine but do you think I will have seizures once I completely stop taking the medication. Its been almost a decade since I havent had any. Basically my questions are:
1. What is the probability of having a seizure after I stop with the medication?
2. Do you believe surgery is necessary to remove the cyst or should I just live with it?

[Rowena Santos, MD]

Hi mayan1021,

How are you? I’m sorry to hear about your insurance problem. It’s true, stopping your medications could lead to more seizure. You could ask your doctor what other medications you can use. It’s good that your EEG result was normal. You should also know about the triggers that could cause seizure such as infection, drugs, lack of sleep or hormones. : Here’s a link for the triggers: http://www.epilepsy.org.uk/info/triggers.html

What kind of cyst do you have?  Do you have a recent MRI? Would you know if the size of the cyst has increased? There are specific types of cysts. They are named for the type of tissue from which they arise and for their contents. The most common cysts found in the brain are arachnoid, colloid, dermoid, epidermoid, and pineal cysts. Treatment for an arachnoid cyst may be “watchful waiting,” or it may be surgery. If the cyst is small and is not causing problems, just leave it as it is. It is important to keep your appointments for follow-up scans on a regular basis, as these cysts may slowly continue to enlarge. If the cyst is causing symptoms or is located in a part of the brain where continued growth would cause a problem, your doctor may suggest surgery to remove the cyst. The usual procedure is to drain and attempt to remove the entire cyst, including its outermost lining.  You can learn more about this through this link: http://www.abta.org/sitefiles/sitePages/4F77F57A14D6EBBE5C3FBC447B78FD57.pdf

I hope this helps. Take care and please do update us.