Dear XXXXXX

Thanks for the query.

1. While majority of patients recover on conventional treatment, some patients remain uncontrolled. The adverse factor in your wife's case is overweight which has recently aggravated.

2. Uncommonly propranolol can result in weight gain; but debate continues on cause and effect relationship.

3. Treatment options that can be considered by your doctor are as follows:
- Additional drug like frusemide can be considered. Corticosteroids will be temporary and in emergency situations only (because of its side effects)
- Repeated lumbar punctures and wait for natural recovery
- In her case surgery can be considered early in view of vision deterioration. Optic nerve sheath fenestration or cerebrospinal fluid diversion (via a lumboperitoneal or ventriculoperitoneal shunt) are the surgical options.

4. Regarding a doctor in Bangalore, I do not have any personal reference at Bangalore. Perhaps the customer support team from XXXXXXX can help you. Please write to them.

Hope I have answered all your queries. Let me know if you need further information.

Regards
Dr. Pratap

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Dear XXXXXX

Thanks for writing back.

Personally I am not aware of Dural Venous Sinus Stenting being done in India. In general, they are effective in 30-40% cases and this is less than 70-90% response with shunt surgery.

Let me know if you have further enquiries. If all your queries are answered, please close this discussion

Regards
Dr. Pratap

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