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Benign neoplasms of cranial nerves - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1653 Questions
User :   What are typical symptoms of benign neoplasms of cranial nerves and some treatment alternatives?
Doctor :   Hi
Doctor :   Dr
Doctor :   the causes of tumors of cranial nerves include accoustic neuromas within the cranial cavity
Doctor :   there are 12 cranial nerves
Doctor :   in total
Doctor :   any tumor that affects each nerve and specific to the location of the tumor can cause different symptoms
Doctor :   involvement of the ear - can cause ear ache, tinnitus, dizziness, feeling unbalanced, etc
Doctor :   it can also cause decreased hearing
Doctor :   involvement of the ocular cavity - can cause retroorbital pain, headache, vision problems , etc
Doctor :   increase in intracranial pressure due to the tumors can cause - nausea, vomiting, headache, loss of consiousness, seizures, and so on
Doctor :   involvement of the facial nerves can cause dysphagia, loss of taste, ear ache, difficulty chewing, etc
User :   Patient started with bad ear infection, two surgeries-radical mastoidectomy-ear clear now-has parallalisis on left side face down to throat area, hearing in that ear is gone, headaches, loss of leg strength and falls sometimes, getting MRI Friday-second one, had spinal tap too two weeks ago
Doctor :   involvement of the trigeminal nerve - causes trigeminal neuralgia, facial numbness etc
Doctor :   may i know his age ?
Doctor :   probably he might have CSOM, that got complicated with temporal absess in the brain that can cause all such issues
User :   83 and face looks like he has had a stroke, taste is not good either
Doctor :   CSOM = chronic suppuratve otitis media
User :   What does that mean?
Doctor :   yeah, this is due to facial nerve involvement within the middle ear
Doctor :   chronic suppuratve otitis media - is a chronic infection of the middle ear cavity
Doctor :   the symptoms seem to be due to temporal lobe absess
Doctor :   the MRI will find it
Doctor :   if the doctors were suspecting stroke, they would have got a CT scan
User :   Ok that makes sense butENT doc says ear ia clear now of infection patient cannot swallow, has feeding tube in stomach now
Doctor :   as i said, the facial nerve damage has caused dysphagia, difficulty to swallow
Doctor :   in addition , the absess can cause pressure on the midbrain structures, which control the nerves of the throat and other structures
User :   This has been going on since ear infection started in October, tried PIC line antibiotics for several weeks at a time. How can this be treated and hopefully cured?
Doctor :   the temporal absess may need drainage
Doctor :   and treatment with specific antibiotics based on the blood culture
Doctor :   he may need IV antibiotics
Doctor :   THE MRI would give the clear picture of the further management
Doctor :   have you followed my comments ?
Doctor :   Do u have any doubts ?
User :   Has had many iv antibiotics, and could not get culture
Doctor :   may i know which antibiotics have been given ?
Doctor :   brain absess is a difficult infection to treat , as it can spread, and form a foci within the brain
Doctor :   if it is a large absess , it can form a enclosed cavity, where antibiotics may not reach
Doctor :   in that case, a surgical drainage of the infected absess may be required
User :   Is a temporal bases considered a tumor
Doctor :   no
Doctor :   it is not a tumor , but it can cause symptoms similar to a tumor due to pressure effects
User :   I meant temporal absess
Doctor :   i meant the same
Doctor :   any absess in the cranial cavity has no place to go anywhere else
Doctor :   so it exerts pressure on the brain and other structures affecting their function
User :   Do not have antibiotic names-it is my father in law.
Doctor :   ok
Doctor :   for your informaiton, the treament of choice for any brain absess if surgical drainage
Doctor :   neurologically intact patients who are unable to undergo necessary procedure and in whom pathogens can be identified from other specimens, and particularly if the abscesses are small can be treated with antibiotics
Doctor :   but the efficacy may not be that good when compared to surgical drainage
User :   Is a tumor often associated with this condition?
Doctor :   the duration of treatment of antibiotics is for 4-6 weeks , when used alone
Doctor :   no
Doctor :   tumors are not associated in this way
Doctor :   when absess is excised, surgically , treatment is needed with antibiotics for 3-4 weeks
Doctor :   i hope i have cleared your doubts
User :   Ok, any other thoughts, warnings, suggestions?
Doctor :   the treatment will depend on the MRI findings,
Doctor :   and once proper therapy is given, and the absess drained, all the issues will recover soon
Doctor :   thanks for consulting me here
Doctor :   I hope this helps
Doctor :   take care and bye for now
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