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Neurology (Expert Forum)
Re: 6 mm. Cerebral Tonsil Herniation...Will It Get Worse?
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Re: 6 mm. Cerebral Tonsil Herniation...Will It Get Worse?
by CCF Neuro MD*, Jan 01, 1995 12:00AM
Posted By CCF Neuro MD* on November 22, 1998 at 14:04:33:
In Reply to: 6 mm. Cerebral Tonsil Herniation...Will It Get Worse? posted by Anneliese on November 22, 1998 at 13:51:46:
Hi CCF, I am sorry to be such a pest on this site. I have recently switched HMO for getting refferred to Pediatric Neurosurgeon who specializes in Arnold-Chiari Malformations. My condition has been getting worse with numbness in my neck and arms that seem to never go away. If I move my head I get dizzy. I am having a great deal of trouble trying to walk because of balance and dragging my legs. Plus, not to mention bladder/bowel problems. I am worried that things are progressing for me. My primary tells me this is not neurological problem but combination of possibility inner ear disease and carpal tunnel. But, my problem is I have difficulty understanding this concept because carpal tunnel would effect my arms only not my legs. Is Arnold-Chiari Type 1 always asymtomatic? Is it stable condition or can I expect maybe further problems down the road. It is funny all these symptoms started three years ago with no let up. I have been ruled out on MS. But, Mri shows both enlarged ventricle with increase abnormal axial fluid- does this mean hydrocephalus? Plus, Not to mention two different NeuroRadiologist noticing the ACM with 6mm herniation-reccomending me refferal to neurosurgeon if clinical evidence are present. Well with all my symptoms are would think this would be considered but so far at this time no one has even considered this a problem.
I have wrote to 3 neurosurgeons specialists in ACM. Told them my case history...They all told me to get second surgical opinion. Well, problem is all do I do that when I can even get first opinion of neurosurgeon?
I really wish I had the money to come out and see one of your specialist at CCF but unfortuantly I can afford to do that. But, You sound like a wonderful group of doctors....I want to thank you all for trying to help me over this site. It is so frustrating not beable to find help for all my problems. It makes me feel like just giving up and figuring when things get to bad just ending all my problems for good.
Thanks Sincerely, Anneliese
Dear Anneliese,
I think that you need an evaluation by a neurologist/neurosurgeon for your symptoms. A Chiari type 1 Does have neurological symptoms associated with it. The symptoms typically do not occur until adult life but can include increased intracranial pressure resulting in a headache, ataxia/incoordiantion, progressive spastic weakness of the arms or legs, or syrngomyelia (segmental muscle atrophy and sensory loss). There are additional symptoms that are possible based on the structures involved. You have had the first step in the diagnosis--An MRI to confirm the lesion. If the symptoms are progressive, surgery may be an option. Once again, I would recommend an evaluation by a neurologist or a neurosurgeon. Progressive symptoms due to a chiari malformation must be ruled out. If this is done so succesfully, then treatment of "CTS" and "inner ear problems" must be carried out. Discuss this with your doctor, if he is reluctant to pursue this further, then I would recommend getting another oponion. Good Luck.
In Reply to: 6 mm. Cerebral Tonsil Herniation...Will It Get Worse? posted by Anneliese on November 22, 1998 at 13:51:46:
Hi CCF, I am sorry to be such a pest on this site. I have recently switched HMO for getting refferred to Pediatric Neurosurgeon who specializes in Arnold-Chiari Malformations. My condition has been getting worse with numbness in my neck and arms that seem to never go away. If I move my head I get dizzy. I am having a great deal of trouble trying to walk because of balance and dragging my legs. Plus, not to mention bladder/bowel problems. I am worried that things are progressing for me. My primary tells me this is not neurological problem but combination of possibility inner ear disease and carpal tunnel. But, my problem is I have difficulty understanding this concept because carpal tunnel would effect my arms only not my legs. Is Arnold-Chiari Type 1 always asymtomatic? Is it stable condition or can I expect maybe further problems down the road. It is funny all these symptoms started three years ago with no let up. I have been ruled out on MS. But, Mri shows both enlarged ventricle with increase abnormal axial fluid- does this mean hydrocephalus? Plus, Not to mention two different NeuroRadiologist noticing the ACM with 6mm herniation-reccomending me refferal to neurosurgeon if clinical evidence are present. Well with all my symptoms are would think this would be considered but so far at this time no one has even considered this a problem.
I have wrote to 3 neurosurgeons specialists in ACM. Told them my case history...They all told me to get second surgical opinion. Well, problem is all do I do that when I can even get first opinion of neurosurgeon?
I really wish I had the money to come out and see one of your specialist at CCF but unfortuantly I can afford to do that. But, You sound like a wonderful group of doctors....I want to thank you all for trying to help me over this site. It is so frustrating not beable to find help for all my problems. It makes me feel like just giving up and figuring when things get to bad just ending all my problems for good.
Thanks Sincerely, Anneliese
Dear Anneliese,
I think that you need an evaluation by a neurologist/neurosurgeon for your symptoms. A Chiari type 1 Does have neurological symptoms associated with it. The symptoms typically do not occur until adult life but can include increased intracranial pressure resulting in a headache, ataxia/incoordiantion, progressive spastic weakness of the arms or legs, or syrngomyelia (segmental muscle atrophy and sensory loss). There are additional symptoms that are possible based on the structures involved. You have had the first step in the diagnosis--An MRI to confirm the lesion. If the symptoms are progressive, surgery may be an option. Once again, I would recommend an evaluation by a neurologist or a neurosurgeon. Progressive symptoms due to a chiari malformation must be ruled out. If this is done so succesfully, then treatment of "CTS" and "inner ear problems" must be carried out. Discuss this with your doctor, if he is reluctant to pursue this further, then I would recommend getting another oponion. Good Luck.
