nystagmus, dysmetria, and dizziness

[ingcam]

Hello,
I am 38yo female s/p rt. cp angle cyst fenestration 10/02.  I suffered from continuous state of dizziness, with occasional vertigo, tinnitus, ataxia.  Surgery complete success.  Lately with bouts of vertigo with mild dizziness (compared to before surgery).  I went to my neurologist who told me I have nystagmus when looking left, dysmetria, ataxia.  I have severe facial pain occasionally on the right.  My face feels heavier on this side-sometimes.  I had the flu a few weeks ago and have felt weakness in my extremities and fatige (greater in the morning believe it or not). My speech is slurred in the AM and have trouble saying some words- like my tongue feels heavy   As the day goes on my speech gets better but if I am tired at night it happens as well.  Occasionally at night when I am tired or when I am reading my eyes seem to unfocus and I start seeing double.  I often find myself closing my right eye when reading.  I do have some numbness in my left foot and more weakness in that leg.  I am now feeling like I am having trouble remembering things or I will do something and not remember doing it.  I feel like I am fighting fatigue and am really "racking my brain" just to function normally.  
I did not tell my neurologist about all these issues because frankly I didn't want to seem like a nut job.  Ordered an MRI with "thin cuts" of my posterior fossa with contrast. I am a traveling nuse and convinced him that I would get the scan done after I complete my current assignment.  I have had an MRI 1 yr ago that was normal- If nrml. again what would you suggest?

[CCF-Neuro-M.D.-PW]

Your symptoms could localize to the CP angle, so a recurrence of the cyst would be the first thing to look for with an MRI scan. Depending on the nature of the cyst, they can recur unless the entire lining of the cyst is removed which can be a very big/messy operation. If the cyst was due to a tumor then there are always risks of reoccurence of the tumor. If there is no mass, the MRI should also look at the blood vessels (arteries and veins) to lookfor any blockages which might cause a lack of blood flow to these areas. If these are normal , a referral to an oto-neurologist may be required as sometimes it is hard to seperate peripheral vertigo/ataxia (from an inner ear problem) from central nervous system vertigo. Also an examination of the spinal fluid for abnormal cells or infection may be necessary if the MRI does not make the diagnosis apparent.

Good luck

You shoud tell your neurologist the whole story, you can never tell that you might be omitting a vital clue to your diagnosis which may otherwise elude the doctors.