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- To: Multiple recipients of list CLIN_NEUROPHYSIOL <CLIN_NEUROPHYSIOL@LISTSERV.UMU.SE>
- Subject: HELP!
- From: Wang Shimeng <smwang@VENUS.SHNET.EDU.CN>
- Date: Wed, 24 Jan 1996 16:35:11 +0800
- Reply-To: Professional discussions of neurophysiology <CLIN_NEUROPHYSIOL@LISTSERV.UMU.SE>
- Sender: Professional discussions of neurophysiology <CLIN_NEUROPHYSIOL@LISTSERV.UMU.SE>
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
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.
Wang Shimeng & Chen Xi
Department of neurousurgery, Shanghai Renji Hospital Shanghai, Shanghai 200030, P.R.China