Hello Doctor



name: Subha Datta

age: 27

gender: female

marital status: married (2.5 years)

health: normal, medium height, weighing 53kgs, BP at 120/80

allergic to: dust, mild sinusitis



Current problem: lost responsiveness in left hand and flickering of left eye that generated further anxiety and led to passing out. The pass out lasted for an hour or so. Happened on 14th Aug night at around 11pm. Left hand was numb and was unable to hold anything during this phase. Left eye started flickering and there was a feeling of ear blockage. Head was heavy and breathing was very difficult.



Went to a Neurologist. Was advised to do a MRI (1.5 tesla) with contrast. Result shows:



"well defined rim enhancing lesion in the right parietal lobe, posterior to the central sulcus. It shows thick enhancing wall with nonenhancing necrotic center. The margin of the lesion is hypointense on T2 and isointense on T1 sequence. No evidence of enhancing mural nodule within the lesion. Moderate perilesional white matter oedema is seen in the right fronto-parietal region casing effacement of the adjacent sulci. No evidence of midline shift.



The lesion measures about 1.1 X 1.2 X 1.0cms (supero inferior X AP X transverse)



Features are suggestive of infective granuloma, tuberculoma



Everything else in the report is normal except a prominent venous structure in the deep white matter of the right frontal lobe extending from the subependymal region of the frontal horn of right lateral ventricle to the interhemispheric fissure where it is draining into the superior sagittal sinus. Multiple thin enhancing venous tributaries are draining into this venous channel demonstrating ‘medusa head’ appearance – suggestive of incidental venous angioma.”



Doctor advised that it is Brain TB and advised the following medicines:



AKT4 (for TB)

Benadon 40mg (to resist neuro related side effects)

Epilive 500mg (to handle seizures)

Omnacortil 40mg+10mg (steroid to fight the swelling in the brain)

Zevit (multi vitamins)



Went to a 2nd Doctor.



He advised that it looks more like a parasital cist (like a tapeworm?) and advised that the treatment should be on that direction first because the results are indicative of either a parasital cist or tuberculosis



He advised the following:



Epilive 500mg (to handle seizures)

Omnacortil 40mg only (steroid to fight the swelling in the brain

Pantocid 40mg (to prevent from gastritis that may occur due to medication)

Zentel 400mg X 2 (for the parasital cist)



Can you please advise what is the right direction I should be taking here?





Regards

Subha Datta

+91 9689 002 150