Health

Ask Health Experts and Get Answers to Your Health Question ASAP

Ask an Expert,
Get an Answer ASAP!

Health

Phophalia - i have an arachnoid cyst and a pineal cyst which

Customer Question
hello Dr Phophalia -...
hello Dr Phophalia - i have an arachnoid cyst and a pineal cyst which are now squashing each other and displacing the local brain anatomy. my symptoms are vertigo, balance issues, headaches, nausea and vomiting, very poor memory (especially temporal) right side weakness, weird twitches (intermittent ) and possibly absences. i also have a condition called silent sinus syndrome which causes strange visual problems. My ENT specialist believes that my balance and nausea problems are caused by the arachnoid cyst, my neurologist believes that those broblems are caused by a combination of BPPV and mal(something) ie - inability to compensate for movement (especially after a sea journey) but i have not travelled more than 3 miles in the last 15 years and then, only by car or bus. i have had head injuries in the past but , after initial recouperation, have been ok. my symptoms started about 4 years ago, and have steadily worsened. the NHS neurosurgeons do not like to touch any non-malignant growths in the brain, but i am now effectively housebound and unable to do many basic things for myself. would surgery to drain/remove cysts be more beneficial or would the risks outweigh any benefit?
JA: Is the headache episodic or daily? And what about nausea?
Customer: i have a low grade headach constantly that turbos about twice or more a week for several hrs. the nausea happens on head movement and vomiting signals onset of mega headache
JA: Anything else in your medical history you think the doctor should know?
Customer: i was a super fit athlete and iceskater with above average balance. i have suffered bereavement but that has been throughout my life and i am now past the (lost ) 18 month stage since the last one. i have low blood pressure and slow heartbeat but no diabetes, heart problems and my cholesterol is low
Submitted: 1 year ago.Category: Health
Show More
Show Less
Ask Your Own Health Question
Answered in 8 hours by:
9/30/2016
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 1 year ago
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 36,850
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Verified

Hello,
I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

Let me at the outset tell you that surgical risk outweighs the benefit. Arachnoid and pineal cysts are rare to cause all of your symptoms. I would like to now your age and gender, and than we can discuss all of your symptoms collectively. Here I am just handling the balance coordination initially and than we would discuss rest of them too.

Following are the possible causes of balance and in coordination problem;

1) Sitting balance and arising from chair problem; proximal muscle weakness, arthritis, or neurologic disease are the causes. Treatment is muscle-strengthening exercises, and treatment of specific conditions, such as arthritis.

2) Neck turning and extension; Neck arthritis (cervical arthritis, cervical spondylosis), or vertebral-basilar insufficiency can cause this. Treatment options include avoidance of quick head-turning and physical therapy.

3) Standing balance; causes are orthostatic hypotension, cerebellar disease, sensory deficits, muscle weakness, or pain. Treatments are muscle strengthening, using an assistive device, improved foot care, medication adjustment, and treatment of specific diseases.

4) Unstable turning around; causes to consider are cerebellar disease, hemiparesis (stroke), visual field cut, or reduced proprioception (sensation). Treatment possibilities are assistive devices, proper shoes and gait training.

5) Unsafe sitting down; may have proximal muscle weakness or poor vision. Treatment options include muscle strengthening, raising the height of the seat, and visual assessment.

Thus these issues are usually result of composite issues:

You may need following investigations (if not done;

a) Muscle charting for the muscle strength

b) MRI with contrast and magnetic resonance angiography of the brain and spine

c) Electromyography

d) Blood work like CK which is a muscle enzyme.

e) Parathyroid hormone assay

Mainstay of the treatment is usually physiotherapy / physical therapy.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Ask Your Own Health Question
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 1 year ago

I would also recommend colored doppler study of the carotid arteries (neck arteries which take blood to the brain) and MRI with gadolinium contrast; if not done yet. These may show narrowing of the arteries and resultant decrease in blood flow, which in turn may be responsible for your all of the symptoms. Acoustic neuroma too is another diagnostic possibility for your manifestations, which also would be ruled out by it.

Following are the investigations which may help in clinching the diagnosis;

1) audiometry,
2) vestibular tests.

The most commonly performed vestibular tests are as follows:

Electronystagmography (ENG)The rotating-chair test, also referred to as sinusoidal harmonic acceleration (SHA), Computerized dynamic posturography (CDP).
3) blood tests for autoimmune disorders,
4) computed tomography (CT), and magnetic resonance imaging (MRI).

5) The saccadic test
6) The gaze test
7) Pursuit eye movements test
8) Optokinetic Nystagmus test
9) Head shake nystagmus test.
10) Positional nystagmus testing
11) Bithermal calorie test.
12) Rotating chair test.

13) An alternative to the rotating-chair test is the active head-rotation test,

14) Computerized dynamic posturography

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.

Ask Your Own Health Question
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 1 year ago

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.

Ask Your Own Health Question
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 1 year ago

My goal is to provide you with the best service possible. If you feel I have done so, then an "Excellent Service" rating is greatly appreciated! If not, please click "Reply" to let me know how I can better assist you with any additional information or clarification.

Thank you very much for the opportunity to be of help!

Ask Your Own Health Question
Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 36,850
36,850 Satisfied Customers
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine

Dr. Arun Phophalia is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Family Physician

Family Physician

Doctor (MD)

5,660 satisfied customers

Emergency Medicine and Family Practice for over 26 years

Nurse Milli, RN

Nurse Milli, RN

Nurse (RN)

4,051 satisfied customers

20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.

Dr. Ketch

Dr. Ketch

Doctor

102 satisfied customers

Medical Degree, Former Assistant Professor at School of Medicine at Yale University

DrRussMD

DrRussMD

Doctor (MD)

5,095 satisfied customers

Practice Director

Dr. Arun Phophalia

Dr. Arun Phophalia

Doctor (MD)

36,850 satisfied customers

MBBS, MS (General Surgery), Fellowship in Sports Medicine

Dr. Chip

Dr. Chip

Doctor (MD)

14,036 satisfied customers

Over 20 yrs of Family Practice

Dr. Mark

Dr. Mark

Doctor (MD)

6,234 satisfied customers

U.S. Physician/Surgeon in Neurosurgery

< Previous | Next >

Related Health Questions
Well I had a blood tests recently and the only 'flag' was
Well I had a blood tests recently and the only 'flag' was monocytes 15.9 … read more
Dr. Arun Phophalia
Dr. Arun Phophalia
Doctor (MD)
36,850 satisfied customers
My jaw is very swollen, it's even changing the shape of my
My jaw is very swollen, it's even changing the shape of my face. It is not particularly painful, no tooth pain, but I can't close my mouth … read more
Mark Bornfeld
Mark Bornfeld
General Dentist
Doctoral Degree
243 satisfied customers
I woke up with chest congestion, wheezing, productive cough,
I woke up with chest congestion, wheezing, productive cough, aches, chills and low grade fever of 99.8...wondering if I should stay home from work or push through … read more
Dr Josh
Dr Josh
Doctor
B.A.M.S.
6,442 satisfied customers
I've notied over the last few weeks that my resting heart
I've notied over the last few weeks that my resting heart rate is over 100 pretty constantly. … read more
Dr Josh
Dr Josh
Doctor
B.A.M.S.
6,442 satisfied customers
Doc..well the furniture is moving around the ship again
Good morning doc..well the furniture is moving around the ship again doc..feel pretty sick in my belly.. yesterday too..i went to bed the other night and woke at 4 am and pretty sure realised i didnt … read more
Dr. Chip
Dr. Chip
Doctor (MD)
M.D.
14,036 satisfied customers
I have been having ongoing gastro issues over the past 7
Hi there, I have been having ongoing gastro issues over the past 7 months, with pain varying around several areas. I have had several blood tests, ct scan and a colonoscopy within this period which ha… read more
Dr. Arun Phophalia
Dr. Arun Phophalia
Doctor (MD)
36,850 satisfied customers
I was asking about a bump on my forehead and got bumped off
I was asking about a bump on my forehead and got bumped off your site, and in addition, I was not able to use paypal … read more
Dr. Arun Phophalia
Dr. Arun Phophalia
Doctor (MD)
36,850 satisfied customers
Hot inside. Just a moment...I'll get my wife, she's says
Just a moment...I'll get my wife, she's says throat and below … read more
Dr. Arun Phophalia
Dr. Arun Phophalia
Doctor (MD)
36,850 satisfied customers
There feel like I haven't talked to you forever. small spot
Hey there feel like I haven't talked to you forever. Hey small spot on my back I think it's part of a pimple just wanted to run it by you thanks… read more
Dr. Chip
Dr. Chip
Doctor (MD)
M.D.
14,036 satisfied customers
Is it possible to get appetite loss from ciprofloxin and how
Is it possible to get appetite loss from ciprofloxin and how long can this last after stopping the med.… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,981 satisfied customers
I've been on celexa for over a year and wondered if I Can
I've been on celexa for over a year and wondered if I Can take Nyquil … read more
Dr Josh
Dr Josh
Doctor
B.A.M.S.
6,442 satisfied customers
My BP is 134 over 93. Well there was a sudden onset.
My BP is 134 over 93 JA: Is this consistent, or is there some fluctuation in blood pressure? Customer: Well there was a sudden onset JA: Anything else in your medical history you think the doctor shou… read more
Richard Han
Richard Han
Pediatrician
Post-Doctoral Degree
525 satisfied customers
Feetswelling blue on the sides of feet. Pain canwalk good.
Feetswelling blue on the sides of feet JA: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)? Customer: Pain canwalk good JA: How long have you had the pain? What seem… read more
Dr Ted Manos
Dr Ted Manos
Self Employed
MD
791 satisfied customers
I have intermittent ear pain and fullness in my left ear. It
I have intermittent ear pain and fullness in my left ear. It comes and goes a few times a day but isn't too bothersome so I figured it would go away on its own. However I have just found a lump behind… read more
Dr. Arun Phophalia
Dr. Arun Phophalia
Doctor (MD)
36,850 satisfied customers
I have had anal itching for about 2 months and it is getting
I have had anal itching for about 2 months and it is getting worse. I have been to the dr and he Gave me a vagus last cream bc he said i have yeast in my vagina and anus.. the cream is making it worse… read more
Dr.M.D.Mazumdar
Dr.M.D.Mazumdar
Consultant Gynecologist
MBBS. MD (Obstetrics and Gynecology
3,688 satisfied customers
My partner and I have been trying for a baby for a few
My partner and I have been trying for a baby for a few months now, not having sex each and everyday though but a few times a week. She missed her period for 3 weeks and we thought she must be pregnant… read more
Dr. Muneeb Ali
Dr. Muneeb Ali
Senior Registrar Critical Care Medicine
Doctoral Degree
7,245 satisfied customers
I have a metallic tasting production when I cough. I can
I have a metallic tasting production when I cough. I can feel the constant sinus drip. I have bouts of dry unproductive coughing with a tyrannical tickle in throat. This has been going on for 2 months… read more
Dr Ted Manos
Dr Ted Manos
Self Employed
MD
791 satisfied customers
I just woke up and my blood pressure is 165/102. I have a
I just woke up and my blood pressure is 165/102. I have a severe headache that woke me so I immediately went to check my blood pressure. At what point should you go to the hospital?… read more
Dr. Muneeb Ali
Dr. Muneeb Ali
Senior Registrar Critical Care Medicine
Doctoral Degree
7,245 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x