HELP!

[Wang Shimeng <smwang@VENUS.SHNET.EDU.CN>]

Dear Sir/Madam,

   We admitted a 20-year-old junior on December 16th,1995 with the diagnosis of
 pituitary adenoma. On December 28th,1995, we totally removed tumor through
 transphenoid approach. The pathological result was Chromophobic
 adenoma(PRL adenoma).
   Except diabetes insipidus, the condition of the patient was stable after the
 operation. She was conscious ,orientated and ate well.  But on January
 4th,1996,  she lost her consciousness and had the convulsion of left upper
 extremity and facial muscle spasm.  This attack lasted about only several
 minutes. Since that time attacks of the same kind occurred intermittently. The
 attacks sometimes involved only one hand (either right or left), sometimes
 both. Since January 9th, the attack lasted continuously.  She was comatose and
 pupils fixed all days.  The temperature was also high, 38.5'C to 39'C. The
 blood pressure was stable, 18/12 kpa.  CT scan was conducted for two times, but
 nothing positive have been found. We have used  valinumg for muscular injection
 or introveneous infusion, Dilantin(0.1 tid*7 days), Tegretol(0.1 tid*5* days
 and 0.2 tid*8 days) in order to control the attack, but she always had facial
 muscle and neck spasm. After operation, she was treated with large dose of HC
 200mg/day for 7 days,  After that HC dose was decreased and she was treated
 with small maintainent dose until now. We used DCT to control her urine volume.
 Her urine volume decreased to 2000ml per day.

The following are the result of  some supplementary examination:

96-1-16 CSF: RBC 4*10^6/L, WBC 2*10^6/L, Protein 0.23G/L,
        CL~ 115mmol/L, Glucose 5.2mmol/L,   ICP 180mmolH2o
96-1-16 Blood: Calcicum: 2.14mmol/L, Phosphate 0.5mmol/L
96-1-9  Blood Glucose: 6mmol/L
96-1-11 Peripheral Blood: WBC 11.4*10^9/L, N 84%, L 12%
96-1-14 Peripheral Blood: WBC 18.6*10^9/L, N 95%, L 5%
96-1-22 Peripheral Blood: WBC 13.3*10^9/L, N 82%, L 17%
Blood-Gas analysis and Blood eletrolyte was normal.

   We have used Fortum 6.0 G/day, then Grythromycin 1.0 and Chloramphenicol
1.5 infusion,but the patient still had intermittent fever for almost all days.
   We are not sure what the cause  of the patient' attack is. We were eager to
 acquire any help or advice from you.

Best Regards,

Wang Shimeng & Chen Xi

            Department of neurousurgery, Shanghai Renji Hospital Shanghai, Shanghai 200030, P.R.China