Cavernous Hemangioma

[Jo-An-Jorgensen]

  I really hope someone can shed some light on my mother's problem...
  On July 28th she had 2-3 seizures..After an MRI the
  doctor's diagnosis was a cavernous hemangioma..she was put on 300 mg of dilantin. 1 month later her dilantin level was decreased to 260 mg, because she had an EEG and was still showing seizure activity, but was feeling very sick from the dilantin.  She now is experiencing what we believe to be anxiety attacks where she feels as if she cannot breathe. Her appetite is nearly non existent and recently she has become very confused.  She seems to not be able to get her words out and when she does she will call her feet , shoes and the couch , a telephone, etc... She has a hard time reading and also she has lost 50 percent of her right field vision.  The bleed occurred in the left back part of her brain near the vision area.  My question is:
  What can be done for her..A neurosurgeon has said that there is a procedure which could eliminate the hemangioma but could risk more vision loss..Is she confused due to the dilantin level being too low or too high...What can be done to increase appetite..What can be done to reduce anxiety....and will this mental confusion clear ... Any comments on the surgery option...She is 68 years old and was never sick a day in her life until this happened..She is losing weight from 105 to 95 now three months later....please advise as soon as possible..Thank you so much!!
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The symptoms your mother is having could be due to very high Dilantin levels, the only way to know is by having the blood levels checked regularly, she may need less Diulantin every day as her weight is decreasing. The loss of appetite could also be due to Dilantin toxicity so this really needs to be checked soon.
Another possible reason for confusion is ongoing seizure activity which does not manifest as full blown seizures , just confusion,anxiety and disorientation. If your mother is not responding well to Dilantin despite high blood levels she may need to add or switch to another drug to control her siezures, there are many options available and I suggest that you consult a neurologist about the options available.
Surgery is an option in this case , it would seem that all of this started when the hemangioma bled, surgery to remove this could damage part of ther visual field (on the right side), this has probably been damaged to some extent already by the bleeding, if her seizures cannot be controlled by medications alone this option may need to be explored.
I think your next step should be to have the Dilantin levels rechecked, and have a switch to a new drug if necessary, under the guidance of a neuroologist.
The appropriate drug therapy could correct a lot of problems including the loss of appetite,anxiety, confusion and future seizures.