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Schwannoma/Neuroma

I would appreciate information about the following:
What is the difference between a neuroma and a Schannoma?  If a person is experiencing neuropathy in the peroneal nerve which is likely caused by a neuroma or a Schwannoma, what is the recommended treatment?  Also, if surgery is the recommended treatment, what risks are entailed in operating on the peroneal nerve?  
Thank you for your assistance.
33 Responses
Avatar universal
Dear Linda:

A schwannoma is a benign tumor of the myelinating cell of the peripheral nervous system.  A neuroma is a benign tumor of a nerve.  Both can cause a neuropathy.  The more likely is a schwannoma.  Unless there is enough compromise to warrant it, surgery is usually not performed.  But, each case is individual.  Most of the risks are dependent on the size and location of the tumor, and the surgeon.  I can't really tell you because I don't know these variables.

Sincerely,

CCF Neuro MD
Avatar universal
Dear Linda:

Schwannoma, created by schwann cells.  Main principle, to create and maintain the myelin sheath that covers and protects the nerve within.  Overabundance of these cells in certain areas cause tumors.  Hence, schwannoma.  They were discovered many moons ago by a German scientist (Dr. Schwan), and believe me... I'm very up-to-date when it comes to discussing this particular arena.  I have Neurofibromatosis and have survived what a trinity of Emory doctors have labeled "a massive, huge and extensive craniotomy" for the removal of benign schwannoma growth on the 7th cranial nerve.  Impingement to the orbital floor of my left eye socket resulted in having to rebuild it.  They excised schwannoma from my optic sheath... and I am alive to tell the story.  But it is another matter altogether.

The main theory to schwannoma control is to observe them because they are very slow-growing tumors.  Observation could last for years and the patient usually calls the shots on when they are to be removed.  It's a hard call to make, but... most schwannoma eventually lead to pain.  My pain warranted the use of morphine sulfate in combo with four other pain meds.  I took pain for over 4 years until I couldn't stand it any longer... and called the shot.  (The shot was called after years of investigative MRI's)

Please, educate yourself to the max if it is you suffering from schwannoma.  I am available if you need more information on this subject at ***@****.

Sincerely,

C Taylor Jenkins (Iam not a physician)
Avatar universal
thanks for your comments

CCF Neuro MD
Avatar universal
Doc,

You're welcome.  And with all my understanding, I hate the dad-gummed things.  Question?  Can excision (shaving) of schwannoma lead to partial restoration of nerve function after many, many, many moons of paralysis?  I ask this because the other day I was checking myself out in the mirror and received the shock of my life.  Namely, movement where there didn't used to be in the lower lip.  I smiled and low and behold, I could even feel it happening!  The upper lip is still motionless, but I actually have a laugh line and a matching dimple.  There is also a fair amount of zapping going on back and forth along my jawline.  Is it possible Doc?  After all this time?  And should I really put the pedal to the metal in the exercise department?  (Incidently, I'm down to 90 mgs of MS- Contin.  I started reduction at 180 mgs.)

Sorry to take up this space, but... strange phenomena is happening in the schwannomal arena and it's a first for me!  Thanks for your time and hopefully, your reply.

C Taylor Jenkins
Avatar universal
To Doc RPS:

You're welcome.  I don't suppose you would give me a passing grade on this chapter, huh?  All kidding aside, I still detest the dad-gummed things, no matter how much data has been digested over the years.

I have a serious question for you, Doc.  It has me somewhat flipped-out to say the least.  We all know that excision of schwannoma carries the distinct possibility (probability) of causing extensive paralysis, correct?  So... what are the chances of regeneration after many, many, many moons of disfunction?  I ask because there is a vast difference between the procedure of clipping a nerve as opposed to shaving its sheath?

I am experiencing movement where there was none for years.  My husband, after my excited display, had to dive for total privacy.  He hadn't seen my laugh line, let alone the matching dimple for years.  My kids kept saying, "Do it again, ma!"

Hey Doc?  This is serious stuff!  I need a little feed-back here.  After being bald as a billiard ball, not to mention everything involved with having such a craniotomy, then to have such a shock... is it possible that "shaving" freed the frozen?  I could use a little expertise here!  What's going on?

C Taylor Jenkins

Avatar universal
Dear C Taylor Jenkins:

A peripheral nerve will die after 18-24 months where the axon does not meet it's end organ (usually muscle).  However, axons can sprout and other nerves can actually take over some of the function of dying neurons.

CCF Neuro MD
Avatar universal
Doc RPS:

Heavy, heavy, heavy.  Like the old Beatle lyric:  "It's getting better all the time..."  Thanks for the info.  It's got to be a classic case of sprouting axons in cahoots with other nerves.  I'm just elated about this.  The dimple gets deeper the  more I exercise.  I see my neurologist 11/3 and I hope it floors him along with all my med reductions.  I'm down on neurotin - 2700 to 2400 mgs.  Ritalin dove from 60 mgs down to 20!  Life's looking good for once after all the bad.  Cool!  I'm in it for the duration.  You were right... slowing down made all the difference in recovery time.  Life is long and I'm gonna live it well.  I count life just a stuff to try the soul's strength on.  Thanks again.

CTJ
Avatar universal
you are welcome

CCF Neuro MD
Avatar universal
Doc RPS:

I'm going for stereotactic radiosurgery tomorrow.  Have to be there all day long.  Wanna know something?  The whole idea scares me and with all the **** I've been through with the craniotomy and all, you'd think it wouldn't.  Reading all the instructions gave me the headache reserved for the headgear I get to be adorned with tomorrow.

I still have a small portion of schwannoma in the deep cavernous that couldn't be surgically removed during the craniotomy.  Should I expect this radiosurgery to "kill" it for good or just "slow" it down, the latter being the true nature of the creepy things (when associated with NF)?  I just want all the growth to stop.  They never seem to stop, Doc.  Energizer Bunnies.  That's what they are.  Keep going and going.  I've been battling them for so long, I want some kind of miracle to happen.

Can I get some kind of reassurance from the "Dynamite Doc"?  My question is:  How long til it grows back, if it grows back?  And do the headgear pins touch the bone?  I'm insecure about this.

CJenkins
Avatar universal
Dear Ms. CJenkins:

I am not sure what to tell you.  Schwannomas are usually slow growing, even in the face of NF.  Radiotherapy will get rid of them but reoccurance is unknown.  The data is plus to minus encouraging but it is sparse and individuals respond differently.  Don't worry about the head attachments, they are necessary for stereotatic guidance (much better than the alternative).  Hang in there.

CCF Neuro MD
Avatar universal
Doc?

I did it... have deep rosy marks on my left temple and three holes where the headgear fastened.  They usually secure with four, but because they removed that section of bone to assess the left temporal region only three were used.  Don't let anyone tell you that radiosurgery is easy.  It may appear "easy", but in reality, it's harsh and fatiguing.  I felt fine, until I got home.  A tremendous headache (no migraine holds a candle to it) set in and nothing could be done for it.  Then I took my evening meds.  Five minutes later I began vomiting and couldn't stop.  A Phenergan suppository ended that ordeal and knocked me out cold.  I woke up so fatigued it took every ounce of strength I had to rise.  The headache was still there, only half as strong.  Food was out of the question and so were my morning meds.  Missing two doses of pain medication took its toll and I realised that I will never have quality of life without them.  I'd be a coiled-up mess-of-a-person without them.  They screw the headset in to the bone and god... it hurt so bad when they removed it because the pressure was gone.  I hope and pray they shut that deep sob down and I never have to deal with it again.  My head is hurting, so...

Thanks for responding,

C Jenkins
Avatar universal
Doc RPS:

I just want to tell you that you've hung in there with me through all this junk.  From HRT and NF, a massive craniotomy and now this.  You may not have said a whole lot, but what you did say helped me down this road I've been thrown upon (heredity decided the route).  We've swapped quotes and they are comfort in themselves.  You ought to use them more often in other posts where applicable.  I must confess something.  I am Lady Jay.  Yes.  Talent runs in the family.  My dad is a retired drummer circa 1935-1965.  Swing was his game and my mom also.  She played trombone (a silver Busher)in an all-female dance band.  My gramps was a piano tuner and trombonist.  I played trumpet, french horn, flute, oboe, then paralysis struck and I did the same on guitar.  It's curious to mention that my great gramps was known throughout Ohio as the Pioneer Singing Schoolteacher.  In short, he was a circuit rider and invented the songwriters wheel.  It's preseved neatly on buggy leather.  Yeah, it runs in the family.  I thought I'd confess that to you.  Now I feel better.  And I'm going to continue my novel and get published.  Thanks for the all-around inspiration for my physician character.  You'll never know how much influence this entire forum has had on that one by your answers alone.  Good neuro's are never a dime a dozen... patients, like musicians are.  Convinced that I am Lady Jay?  Indeed!

Take care, doc... and keep the forum alive!

Yours,

C Jenkins
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