70 Years Old Mother with Brain Lesion (Tb Meningitis)

Hi,

My mother was having sudden seizures and we went to the hospital. Doctor ask for a CT scan and it was noticed that she has lesion with edema in the right frontal lobe. doctor diagnose it as tumor after MRI, and start the medication but also continue with further investigation as in the MRI it was suggested that its metastasis tumor. She went through a lot of tests including ultrasounds, scans and xras. in the end they decide for a lung biopsy and the biopsy was negative for cancer.

Till that time, she was having balance issues, weakness, and the doctor started TB medication Myrin-p and Vita 6. in few days, there was a lot of improvement and she was fine in a a week or two. after two months the doctor change the medication from myrin-p to Refina and thats all. the next day she was having the seizures again. And slowly she start slurred speech and then completely she cant speak. half of her body swells and she was in very bad condition. Then we go for another MRI and we were amazed to see the lesion in right frontal lobe disappeared and now she has lesion on the left frontal lobe. is it possible?

we go to another neurosurgeon and he start levoflox and ask for a MR Spectroscopy. we did it and it suggest a solid/cystic tumor. I am pretty sure its TB but the doctor is insisting its Tumor.

Evidences:

1- if its tumor, how the it move from right frontal lobe to left frontal lobe.

2- The MRS is suggesting a mid-line shift, which is only in Tuberculoma and not in Cystic.

3- Tuberculoma is bigger and tumor is smaller then 2 CM. my mohter has lesion of 3.4 CM.

4- Edema is present while in tumor, there should be no Edema.

we went to almost 3 neurosurgeons and 1 physician, they are basing only on the MR Spectroscopy report and not looking on the patient history, right to left frontal lobe movement of the lesion, and how patient was feeling better with myrin-p.

I have few question if someone can help me.

Can we move back from Rifinah to Mayrin-p forte in TB treatment.

Can all the results be neglected because of a MRS report.

how should I deal with the issue, we don't have any specialized doctors for TB meningitis in our country and we have to go to neurosurgeons.

any help will be appreciated. I have attached the MRS report.

thanks,

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