Case of Juvenile Nasopharyngeal Angiofibroma

A CASE OF JUVENILE NASOPHARYNGEAL ANGIOFIBROMA WITH INTRACRANIAL EXTENSION WITH SEIZURE DISORDER

CLINICAL PRESENTATION :-

Mr A.Bramhankar, 24 years male brought by relatives with the diagnosis of Nasopharyngeal Angiofibroma with Intracranial extension with recurrence, operated thrice, brought with following S/S

  • Convulsions,
  • Stuporous state , unable to recognize the things, peoples
  • Ataxia of both legs, Unable to walk/sit/talk properly.
  • Tendency to fall on right side
  • Sleep disturbed

FINAL DIAGNOSIS:- OPERATED  CASE  OF  LARGE  JUVENILE NASO-PHARYNGEAL   ANGIOFIBROMA  GRADE-3  WITH  INTRACRANIAL  EXTENSION WITH  SEIZURE  DISORDER  WITH  ATAXIA  WITH  RECURRENCE.

Three Surgeries Done

  • First:- A Naso-Pharyngeal Mass Removed
  • Second: – Recurrence with Intracranial Extension. Intranasal Surgery Done.
  • Third: – Again Recurrence with Gross Intracranial Involvement. Surgery done through opening the skull vault and Intranasal Route– Pt got Critical during surgery and saved with difficulty–took very long time to recover but was never normal thereafter.

Surgeons Advice:-

  • After operating thrice, Doctor said that he was in worst condition with brain involvement and he will not live long, die at any time and so that relatives lost hope for him.
  • Again Recurred—took to GMC — All Surgeons Refused Surgery – Pt left to Die

Last Hope

  • As a Last Hope Patient was brought to our Clinic being Carried by Three Relatives, almost lifting him and kept him on bed:-
  • Disoriented, Drowsy,Stuporous
  • Swollen, Bleeding Gums
  • Toxic Look, GC Very Poor
  • Unable to Talk

 Patient as a person:-

  • APPEARANCE: Lean, Thin, Fair complexion
  • HEIGHT: 5’3
  • WEIGHT: 42 kg
  • APPETITE: 2-3 times per day.
  • THIRST: Thirsty+
  • CRAVING: Nonveg+++, sweet+++, clay
  • AVERSIONS: NAD
  • DISORDERED BY: NAD
  • ADDICTIONS/PICA/HABITS: NAD

  Thermals:

  • HOT

LIFE HISTORY(in brief):-

  • He ..
  • .
  • .
  • .
  • .
  • .
  • like a gentleman.

 AFTER PRESCRIPTION

Follow Up:-

After 1 month

  • Patient Started improvement within 1 day with TOXIC LOOK and ATAXIA & COLLAPSE SHOWING IMPROVEMENT.
  • Collapse State Improved Gradually
  • Epistaxis >+++
  • Appetite Improved
  • Ataxia >
  • Appetite Better
  • Convulsions >++

After 2 Months

  • All Improving
  • Convulsions >
  • Ataxia >
  • No Epitasis

After 6 Months

  • All Improving
  • Convulsions >
  • Ataxia >; Walking with support
  • No Epistaxis
  • Comprehension better Understanding >

After 1 year

  • Walking ,talking well
  • understanding better
  • No Epistaxis
  • Anticonvulsants ,Tegretol 1 BD

After 2 years

Only occ convulsions

No other complaints

Doing all activities Normally