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Q. Why is my mom's health deteriorating even after undergoing treatment for anaplastic astrocytoma?

Answered by
Dr. Rajyaguru
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 03, 2017 and last reviewed on: Jun 09, 2021

Hi doctor,

Four years ago, my mom was diagnosed with an anaplastic astrocytoma in the right parieto-occipital region. She underwent radiotherapy and chemotherapy with Temozolomide, which shrunk the lesion. Over the years her mobility has declined significantly. She can only walk a few steps with support. Her recent MRI, which she got last week, showed that her lesion is stable. However, for the past one month, she has been sleeping a lot. Her cognitive function and memory have deteriorated sharply. She has had episodes of being disoriented and is silent mostly, almost dazed. She was in the ICU after her last episode of confusion, drowsiness, right hand and leg jerking. The neurologist said she was probably in a postictal state. Yesterday, after being discharged from the hospital, she was very sleepy again, her head slumped, and she took about five minutes to regain consciousness. Today morning she started dazing again. She is on Keppra 2 g, Lamotrigine 150 mg twice daily, Lacosamide 100 mg twice daily, Frisium 10 mg once daily and Clobazam 10 mg twice a day. She had three episodes of seizures in the last year. The neurologist is confused as MRI has shown chemotherapy-induced changes, but still, her condition is not improving. Please help.

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Hi,

Welcome to icliniq.com.

I understand your mom's case.

  • The most likely reason for her loss of consciousness would be a microscopic spread of the tumor to the areas of the brain which control consciousness.
  • The spread cannot be detected on an MRI (magnetic resonance imaging). The only way to diagnose such a spread would be to take CSF (cerebrospinal fluid) sample and look for malignant cells in it.
  • The reason why your doctors do not seem to have a clue so far is that this is the last diagnosis one can think of and initial diagnosis for impaired consciousness is always seizures or low sodium.
  • As of now, I suggest you should continue using the same medicines and be more aggressive on physiotherapy.

For further queries consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


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