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Neurology (Expert Forum)
perfusion/diffusion scan
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perfusion/diffusion scan
by Laurie__0__0, Feb 18, 1999 12:00AM
I have two questions --
1. I was put on Dilantin for presumed seizure activity. Into day three on the Dilantin I developed an ataxic gait. When my level was checked that week it was 18.5. Have you seen a Pt. develop an ataxic gait with a level that was in the theraputic range? I am off it now and feeling fine.
2. I have a 1 cm lesion in my occipital lobe which does not enhance much wiht contrast. The consensus seems to be to watch the lesion with repeat MRIs every 3 months. Most docs I have seen agree on plan except for the neuroncologist who looked at the results of my perfusion/diffusion test and saw that there was increased perfusion to the area of the lesion and recommended me immediately to a surgeon. I know that this test is fairly new and used by few for diagnostic reasons. Now I am stuck with having to decide if I should go ahead with surgery or not. What is your understanding this method?
Thanks, Laurie 26 yrs. old
Doctor's Answer
by CCF neurology MD MM, Feb 18, 1999 12:00AM
_
The resonse to dilantin like the response to any chemical is very variable
between individuals, the varying response to alcohol is a good everyday
example. This reaction at a theraputic level is not all that unusual .
The perfusion scan reveals the degree of blood flow around a lesion in the
brain, the fact that this is enhanced suggests that the lesion may not
be as inactive as previously thought and would certainly prompt
consideration of early surgery as opposed to the wait and see approach.
This si a small lesion which can be easily treated at this stage regardless of its
exact nature, if a neuro-oncologist has expressed concern I would advise
that you seek a surgical opinion as suggested.
