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Suggest Remedy For Persistent Dizziness With Fainting Episodes
Question: I am 45 year female. I had Brain tuberculomas and got treatment for 2 years. Had two seizures before i started my treatment. The last 3T MRI–BRAIN WITH CONTRAST taken on 10Dec2011 says:
1. Mild enhancing dural thickening (1.7mm) in the right frontal region.
2. No underlying parenchymal edema.
3. No significant interval changes seen when compared to the previous scan dated 12-January-2010.
What does this mean?
I have taken Levera 500mg alone until Oct2014. With this all the medicines taken during the TB course are stopped.
Now i feel dizziness most of the time and i fell down with a "ahh" sound at-least once in a week. When i went to a neuro doctor, she guided me to an ENT specialist. Though i am taking the tablets ENT prescribed for past 2 months, there is no major improvement. Still i fell down once a week. Is this something related to the TB i had or really a ENT problem? Please advice.
I also have sugar, which is out of control right now. It is around 180/220 on an average.
1. Mild enhancing dural thickening (1.7mm) in the right frontal region.
2. No underlying parenchymal edema.
3. No significant interval changes seen when compared to the previous scan dated 12-January-2010.
What does this mean?
I have taken Levera 500mg alone until Oct2014. With this all the medicines taken during the TB course are stopped.
Now i feel dizziness most of the time and i fell down with a "ahh" sound at-least once in a week. When i went to a neuro doctor, she guided me to an ENT specialist. Though i am taking the tablets ENT prescribed for past 2 months, there is no major improvement. Still i fell down once a week. Is this something related to the TB i had or really a ENT problem? Please advice.
I also have sugar, which is out of control right now. It is around 180/220 on an average.
Brief Answer:
Repeat MRI Brain with contrast.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
MRI Brain in 10Dec2011 saying-
1. Mild enhancing dural thickening (1.7mm) in the right frontal region.
2. No underlying parenchymal edema.
3. No significant interval changes seen when compared to the previous scan dated 12-January-2010.
-------It means that mild dural thickening due to inflammation(probably due to tuberculosis) persisted at that time which was contrast enhancing,suggesting that some active inflammation was present at that time.This will make better sense in comparison to previous MRI's.
-No parenchymal edema and no interval changes means rest of the MRI was normal.
If you are clear from the ENT surgeon's point of view,you need to get a fresh MRI of Brain with contrast to see if there is any tuberculous recurrence-like some granuloma sitting at a place,crucial to cause dizziness.
If you have any further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Repeat MRI Brain with contrast.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
MRI Brain in 10Dec2011 saying-
1. Mild enhancing dural thickening (1.7mm) in the right frontal region.
2. No underlying parenchymal edema.
3. No significant interval changes seen when compared to the previous scan dated 12-January-2010.
-------It means that mild dural thickening due to inflammation(probably due to tuberculosis) persisted at that time which was contrast enhancing,suggesting that some active inflammation was present at that time.This will make better sense in comparison to previous MRI's.
-No parenchymal edema and no interval changes means rest of the MRI was normal.
If you are clear from the ENT surgeon's point of view,you need to get a fresh MRI of Brain with contrast to see if there is any tuberculous recurrence-like some granuloma sitting at a place,crucial to cause dizziness.
If you have any further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello doctor,
Thank you very much for your response.
17-Mar-2008 Identified: 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Right frontoparietotemporal diffuse dural thickening and enhancement with a small right frontal focal nodular dural lesion measuring ~11 x 4mm with mild edema in the underlying frontal cortex.
2. ? Tuberculoma –suggested CSF study and meningeal biopsy correlation/follow-up study
01-Dec-2008 2nd 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Post treatment follow up case of right frontoparietal enhancing nodular dural lesion? Tuberculoma.
2. Present scan shows significant resolution of the lesion suggesting good response to treatment.
20-June-2009 3rd 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Complete resolution of the nodule and right frontal edema.
2. Incomplete but significant resolution of the dural thickening. Residual enhancing dural thickening now seen only in the right frontal region (2 mm).
12-January-2010 4th 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Mild dural contrast enhancement along right frontal lobe ~1 mm in thickness.
2. Significant resolution in comparison to 1st MRI dated 17 March 2008. Mild resolution in comparison to last MRI dated 20th XXXXXXX 2009.
10-December-2011 5th HIGH FIELD - 3T MRI–BRAIN WITH CONTRAST
-------------------------------------------------------------------------------
IMPRESSION:
1. Mild enhancing dural thickening (1.7mm) in the right frontal region.
2. No underlying parenchymal edema.
3. No significant interval changes seen when compared to the previous scan dated 12-January-2010.
1. Above is the MRI history. This is for your comparison. What does the history suggest? Does it in anyway suggest recurrence or probability of recurrence?
2. What are the symptoms of recurrence? Note that TB was first identified in 2008 and following are the medicines taken.
AKT4 6 Months
AKT3 7 Months
AKT2 5 Months ++
INH 300mg
Rifampicin 450mg?
Tegrital
Levera/Torleva 250mg (Taken until Oct2014)
Allegra 180mg
Stilnoct 6.25mg
Epitril 0.5mg
Riflux forte
Obimet SR00
Liv 52
B-Active / Multigates
Becosules capsules
3. If MRI Brain with contrast is take now, it will be the 6th time. Will it have any side effects?
4. Can a psychological problem cause dizziness and felling syndrome?
Thank you very much for your response.
17-Mar-2008 Identified: 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Right frontoparietotemporal diffuse dural thickening and enhancement with a small right frontal focal nodular dural lesion measuring ~11 x 4mm with mild edema in the underlying frontal cortex.
2. ? Tuberculoma –suggested CSF study and meningeal biopsy correlation/follow-up study
01-Dec-2008 2nd 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Post treatment follow up case of right frontoparietal enhancing nodular dural lesion? Tuberculoma.
2. Present scan shows significant resolution of the lesion suggesting good response to treatment.
20-June-2009 3rd 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Complete resolution of the nodule and right frontal edema.
2. Incomplete but significant resolution of the dural thickening. Residual enhancing dural thickening now seen only in the right frontal region (2 mm).
12-January-2010 4th 3T MRI–BRAIN WITH CONTRAST
------------------------------------------------------------------
IMPRESSION:
1. Mild dural contrast enhancement along right frontal lobe ~1 mm in thickness.
2. Significant resolution in comparison to 1st MRI dated 17 March 2008. Mild resolution in comparison to last MRI dated 20th XXXXXXX 2009.
10-December-2011 5th HIGH FIELD - 3T MRI–BRAIN WITH CONTRAST
-------------------------------------------------------------------------------
IMPRESSION:
1. Mild enhancing dural thickening (1.7mm) in the right frontal region.
2. No underlying parenchymal edema.
3. No significant interval changes seen when compared to the previous scan dated 12-January-2010.
1. Above is the MRI history. This is for your comparison. What does the history suggest? Does it in anyway suggest recurrence or probability of recurrence?
2. What are the symptoms of recurrence? Note that TB was first identified in 2008 and following are the medicines taken.
AKT4 6 Months
AKT3 7 Months
AKT2 5 Months ++
INH 300mg
Rifampicin 450mg?
Tegrital
Levera/Torleva 250mg (Taken until Oct2014)
Allegra 180mg
Stilnoct 6.25mg
Epitril 0.5mg
Riflux forte
Obimet SR00
Liv 52
B-Active / Multigates
Becosules capsules
3. If MRI Brain with contrast is take now, it will be the 6th time. Will it have any side effects?
4. Can a psychological problem cause dizziness and felling syndrome?
Brief Answer:
Serial MRI's show improvement.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing serial MRI's.
Serial MRI's over the years have definitely shown improvement.
Dizziness can very well be psychogenic.That may be the probable cause in your case.Please start doing regular mental relaxation exercises like meditation/yoga and I hope to see you improve soon.
I don't really think,your once a week dizziness is pathological.
Hope that I have answered your query.If you have some further questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Serial MRI's show improvement.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing serial MRI's.
Serial MRI's over the years have definitely shown improvement.
Dizziness can very well be psychogenic.That may be the probable cause in your case.Please start doing regular mental relaxation exercises like meditation/yoga and I hope to see you improve soon.
I don't really think,your once a week dizziness is pathological.
Hope that I have answered your query.If you have some further questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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