Allan Schumann <[log in to unmask]>
Subject: Re: vision troubles
Jacque,
I had a Pallidotomy last Dec5. It appears that it was a total failure. Since
the operation, I have had very heavy eyes with headaches. Do you have some
ideas on this. thank you.Allan
Allan:
Sorry your pallidotomy did not bring relief. More pallidotomy disasters
should speak up to prevent all the frustrated pwp from signing up so quickly!
You know, it's the same procedure done by Cooper 40 years ago, also with
temporary success, only now with MRI and stereotactic refinement, they hit
the spot more often. What is not advertised is that the ansa lenticularis
[outflow from globus pallidus to thalamus] lies very near other motor
pathways, language connections and visual radiations. Even if the lesion is
perfectly aimed,a small post-op hemorrhage can wreak havoc!
My final pet peeve, is that with the greatest success at pallidotomy, the
patient is off the list of potential cures if transplants ever succeed,
because the area to be stimulated by neurotransmitter is gone.
On to your vision troubles. The precise nature of your trouble is not
clear Do "heavy eyes" mean droopy lids [ptosis]? Bilateral ptosis could
herald a midline midbrain lesion, caused by a tiny drop of blood too small to
see on MRI or a post-op ministroke. A careful neuro-ophth exam should show
other signs of midbrain problems--mild gaze paresis especially trouble
looking up and down, pupils unreactive or of different size, double vision,
nystagmus [bouncing] of the abducting eye on lateral gaze [called an
internuclear ophthalmoplegia], etc.
Are you having trouble seeing the right or the left half of the world?
A visual field loss--specifically an homonymous hemianopic defect-- is not
uncommon after pallidotomy.
Are the headaches present all the time? worse lying down or sitting up?
Located where? Associated with any visual symptoms? Can't make an etiologic
diagnosis without more info... Sounds like you need an exam. What does your
neurologist say?
Jacqueline Winterkorn
