Dr. Foo-Chiang LEE
Consultant Neurosurgeon
Qualifications: MBBS (Malaya), FRACS
Contributing Author, Textbook of Stereotactic and Functional Neurosurgery, 2nd Ed, 2009, Springer (Eds: P. Gildenberg, R. Tasker and A. Lozano)
Member of Organizing Committee, 3rd Annual Conference of the International Association of Neurorestoratology (IANR), Beijing April 2010 http://www.ianr.org.cn/English/index.asp
Dr. Lee Foo Chiang is currently a full time Senior Consultant Neurosurgeon at Sunway Medical Centre. He graduated from the University of Malaya, Faculty of Medicine with Bachelor of Medicine and Bachelor of Surgery (MBBS) in 1977. He joined the Department of Neurosurgery, Institute of Neuroscience, General Hospital Kuala Lumpur in 1978. From 1981 to 1985 he underwent Neurosurgery Fellowship Training of the Royal Australasian College of Surgeons at the Royal Adelaide Hospital and Adelaide Children’s Hospital, South Australia and was awarded Fellowship of Royal College of Surgeons in Neurosurgery (FRACS-Neurosurgery) in 1985.
Upon return to Malaysia in 1985, he held the position of Consultant Neurosurgeon at the Department of Neurosurgery, Institute of Neuroscience, General Hospital Kuala Lumpur until 1988 when he commenced private practice as Consultant Neurosurgeon in various premier private hospitals in the capital city of Kuala Lumpur, including Subang Jaya Medical Centre (now renamed Sime Darby Medical Centre), Tung Shin Hospital, Tawakal Specialist Hospital and Sentosa Medical Centre. In December 1999, he was among the pioneer doctors at Sunway Medical Centre, the tertiary care hospital which he helped to plan and get started.
Over the last 31 years of his Neurosurgical career, he has been to Karolinska Hospital, Stockholm; University of Southern California Medical Centre, Los Angeles; Pitié-Salpêtrière Hospital, Paris; Mannheim Hospital; University of Heidelberg; Free Berlin University; University of Dusseldorf, Germany; Queen Elizabeth Hospital (QEH) Hong Kong; and many hospitals in China e.g. Tiantan Hospital; Beijing Neurological Institute; Shanghai Huashan Hospital; in various capacities including visiting fellow or exchange scholar.
His works on movement disorder surgery (DBS) have been presented in international meetings in Vienna, Amsterdam, and Beijing. He has been a congress speaker for ASEAN Congress of Neurosurgery, as well as national Neurosurgery meetings, and Academy of Medicine of Malaysia meeting. He attends regularly international meetings like the Congress of Neurosurgery USA, ASIAN Congress of Neurosurgery, European and World Stereotactic and Functional meetings. He is also involved in post-graduate teaching and has been invited as a speaker for the Education Course November 2009 for Master of Neurosurgery (MS-Neurosurgery), University Sains Malaysia.
He is an active member of Australasian College of Surgeons, Congress of Neurosurgery USA, World Society of Functional and Stereotactic Neurosurgery and Neurosurgical Association Malaysia.
Dr Lee is a contributing author for the Textbook of Stereotactic and Functional Neurosurgery by Springer, 2nd Edition 2009, and Edited by Gildenberg P, Tasker R, and Lozano A.
Apart from routine Neurosurgery, his special clinical interests include:
Cerebrovascular Surgery including cerebral revascularization (EC/IC Bypass) for cerebral occlusive strokes, Moya-Moya disease using the latest Indocyanine Green ICG Vascular Fluorescence
Functional Neurosurgery for movement disorders like Deep Brain Stimulation for Parkinson’s Disease which he introduced into Malaysia together with fellow Functional Neurosurgery team members, Neurosurgeon Dr. C.P. Chee and Neurologist Dr. M.K. Lee in 2003 with the help of Professor Jamie Henderson of Cleveland Clinic USA.
Minimally Invasive Neurosurgery: Stereotactic Image Guided Neurosurgery and Frame based Surgery which he pioneered in early 1990s in the country.
Fluorescence Guided Tumour resection with 5- Amino-Levulinic Acid (5 ALA), a first among private hospitals in Malaysia.
Motion Preservation Spine Surgery: He is a leading surgeon employing cervical arthroplasty and other minimally invasive spine surgeries.
Clinical Experimental Research Treatment of Neuro degenerative disorders and strokes using Stem Cells as a leading member of the Neural Transplant Team comprising Drs. F.C. Lee, C.P. Chee and M.K. Lee, who were also co-signatories of the 2008 Beijing Declaration on Neurorestoratology.
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Advanced Clinical Neuroscience Associates 
Dear Dr.Lee,
This is Rami the son of Talib Almushcab from Saudi Arabia who you have operated on at Subang Jaya Hospital (SJH) back in 1990. He suffered from head injury resulted from a motorcycle hit and was in coma at government hospital in Kuala Lumpor for two weeks before he was transferred to SJH. All doctors advised that they could not do anything to save our father except you. You gave us hope and after months of treatment, my father did walk and carried normal conversation. My father lived happily after until he passed away in 1998. On behalf of Almushcab family, we would like to thank you for you efforts and special attention that you have provided to our father. To us, you are the best doctor who we know when it comes to neurosurgeon…
Best regards and God bless you wherever you are.
Dear Dr. Lee,
I am an 18 year old female who was recently diagnosed with Chiari 1 malformation with Syringomyelia about 2 years ago and would like to know what treatment is usually recommended for this condition. Is surgery the only option? And roughly how long is the recovery period?
Thank you very much.
Dear Bernice
Surgery is generally the most appropriate treatment for Chiari malformation. You are advised to discuss your clinical condition and scan results with the neurosurgeon. Recovery depends on the extent of surgery.
You can get in touch with Dr Lee at the contacts on this website.
Best wishes, Webmaster
Hi, thank you for the prompt reply and contact details. Would also like to know is this procedure safe?
Thanks and regards,
Bernice
Dear Dr. Lee,
Firstly, thank you for your time reading this message.
Recently my husband is diagnosed with likely Pontine Carvenoma. His condition is worsening as he now has poor control of his right side of his body. At the moment he is seeking treatment at HSAJB. However, the doctor there mentioned that there is no medication and surgery is not recommendable. Yet, from my reading surgery is the only way to handle the situation.
Please advice us. what should we do?
Thank you for your time.
Sincerely,
Baizura
Dear Puan Baizura
If diagnosis is confirmed to be Pontine Cavernoma, this is a complex situation and treatment has to be individualised. Your husband needs to have a detailed clinical assessment together with study of his brain scans. Do consider a second opinion by consulting with a neurosurgeon. Dr Lee can be reached via the contacts on this website.
Best wishes.
Webmaster
Hi…Dr lee…i am Mr lee….my mom had a sickness of trigeminal nerve…and always suffer painful on the left bottom face…she took cabamasifin….and seems like no effect …and tried lamotrigine with painkiller….but doesn’t get better too….i want to get consultation from your expert advise… thanks…
Dear Mr Lee
Trigeminal neuralgia is managed with medications for neuropathic pain. There are a number of combinations which are effective. In case of medication failure, nerve block and microvascular decompression surgery are considered.
Hii Dr Lee. I wish to seek your advice on my condition. I am 50 yo woman who has had a cavernoma in my left brain. I had an operation to move the tumour in 2004, but not all can be removed totally. The doctor has prescribed me with daily dose of dilantin (3 capsules at night). Recently my condition is not stable, I had many blackouts events, almost one or two times on weekly basis, each lasted 5 minutes. Can I seek your advice on this? Thank you very much and I’m waiting for your reply.
Dear Diana
You are advised to refer to your neuro specialist to check whether you are having minor seizures. If so, your medication needs to be adjusted.
Best wishes.
Good day.
Dear Dr Lee,
My MRI result showed that i am having two tavlov cysts at the sacral level. Right side cyst measures at 1.0cm x 0.8cm x 1.7cm (AP x W x CC) while the left side measures at 0.9cm x 0.9cm x 1.7cm. My sympthoms are: shock pain at my left buttock whenever i walk or try to change my sleeping position and constant headace. What is the best treatment to cure this disease? Is it possible to remove the cyst permanently through surgery?
Dear Ain,
Your condition requires thorough study of your clinical status as well as the MRI scans, in order to determine whether the Tarlov cysts are indeed the cause of your symptoms. Only then is it possible to make appropriate treatment recommendations. You are advised to have a consultation with the Neurosurgeon. The contacts are listed on this website.
Best wishes,
Webmaster
Dr Lee, my brother is diagnosed with brain AVM at HUKM. Does he need to redo his MRI if he is keen to consult you on his illness?
Dear Irene,
Your brother’s initial scan needs to be reviewed by the neurosurgeon. Thereafter, you will be advised whether there is need for any further tests.
Dear Lee
Recently my MRI showing that i am having syringomyelia. It is from C1 to T1. Now my clinical presentation showing
1. numbness both hands n slight both feet
2.sometimes having difficulty in swallowing even drinking water
3. Abnormal gait when walking
4. Unable to balance when turning n walking
5. Frequent urine cos having residual urine – unfinished urine
6 .body feel so heavy to lift up
7. I can’t run and walk fast – will fall down
What is your opinion if i go for a surgery? As i know the outcome are usually not as good after operation. Hope u can give me your expertise opinion. Thank you in advance hope u can solve my problem
Dear Madam Chan
In general, the definitive treatment for syringomyelia is indeed surgery. Results are very satisfactory and symptoms should improve. Furthermore, it should prevent further neurological damage. Results are of course affected by the severity of the condition, the patient’s general health status and the surgeon’s expertise.
Do arrange for a consultation with the neurosurgeon for better understanding, in order to give yourself the best chance for recovery.
Best wishes,
Webmaster
Advanced Clinical Neuroscience Associates
Dear Dr.Lee
My husband need to check Keppra level on his blood.Can you suggest a hospital in Malaysia that have it?because i can not find it.
He have AVM di his right brain,and usep keppra 1000mg twice a day.
Thanks,
Mariah
Dear Mariah,
Levetiracetem, LEV (Keppra) drug level is not routinely tested in Malaysia (recommended therapeutic level is 20-40mg/L). LEV is prescribed based on dosage guidelines of 1,000 – 3,000 mg per day, adjusted according to seizure response.
Blood levels were found to be diminished in cases of polytherapy (use of multiple antiepileptic drugs in combination).
Best wishes.
Hi Dr Lee.
Do you do microvascular decompression (MVD) surgery. I have mild to moderate right hemifascial spasm. Being a doctor and administartor in the government agency, this disease is debilitating and distressing. I could not tolerate the side effects of botox injection as everyone seem to notice the semiparalysis of my eyelids not to mention the side effects due to the incomplete closure of the eye.
If you do MVD, may I know your experience in it and the success rate.
Tahnk you for your time.
Hamizah
Dear Madam,
Microvascular decompression (MVD) surgery is indeed an option for refractory hemifacial spasm. Results are rewarding in good hands. As you know, it is a delicate procedure so you are advised to consult the neurosurgeon for a thorough in-depth discussion of the risks/benefits for your situation. You may get in touch with the neurosurgeons at the contacts listed in this website.
All the best, Webmaster
Dear Dr Lee,
I was diagnosed with Cushing disease and agromegaly and was told that this is a rare condition. Is there any statistical datas available For this condition in Malaysia?
As surgery has been adviced as the best option, I noticed that there are 2 approaches namely endoscopic transnasal transsphenoidal and microscopic – What are the differences btw both techniques and Which will be your preferred method?
Lastly, would like to know how many pituitary surgery have you performed thus far and is there any which is similar to my condition. Looking forward to your early reply.
Dear TBL
Your clinical situation requires a detailed analysis of the tumour size, encroachment on to neighbouring structures, its hormonal output and your general medical condition. Based on these, a treatment recommendation will be made on choice of medication, radiotherapy or surgery. The next step will then be decision about surgical approach, such as transphenoidal vs. open surgery. Occasionally, technical obstacles may mandate the latter in the interest of patient safety (e.g. risk of massive haemorrhage not controllable via endoscopic method).
You are advised to consult the neurosurgeon for a thorough discussion prior to making an informed decision.
Best wishes for a good outcome.
Dear Dr. Lee,
My father (56 years old) had a brain surgery due to cerebral aneurysm on November, 2014. After going through some months of recovery, my father now is able to do simple daily routines by himself even driving car and riding bike.
However, there has been a significant degradation on his memory, changes in sleeping quality and some of his behavior:
– He keeps repeating same topic over and over again before changing to other topics and repeating them again.
– He can’t have a real focus on what people are saying.
– He can’t have a good sleep without taking this medicine called Riklona, he takes only half of the suggested dosage though (after consulting with the Neurosurgeon who operated him of course) and it’s enough to keep him sleep for like 4-5 hours at night. But his sleep is very easily distracted even by small voices.
– It seems like he always feels restless and he gets hungry so easily, like after having a quite big portion of meal, he’ll get hungry a few hours later which never happened under his normal condition before.
We’d like to ask for suggestion, is there any medical or non-medical treatment that can help my father gaining back his normal condition or at least make it better?
If Doctor find it’s necessary to meet the patient in personal for further checking, we will try our best to arrange a visit. We really hope this is not a permanent and non-curable effect of post-brain surgery. We really appreciate your respond.
Regards,
Fransisca
Dear Fransisca
If you are certain that your father is getting worse after the initial stabilisation, you are advised to consult the neurosurgeon to assess whether your father may have a delayed complication from the aneurysm. Hydrocephalus and seizures are some possibilities. Other issues may be the side effects of medication.
Once physical causes have been ruled out, do consider depression due to this life changing event, as well as post-traumatic stress disorder.
Best wishes.
Hi Dr, im a 29yr old practicing dental surgeon. I had gone for a bamboo massage on tuesday evening, the very next morning i started getting a sharp pain on the left back side of my head that lasts for approx 1-2sec and a tingling/numbing sensation disperses after. It comes every 1 to 2 min and lasted for the past 24 hours already. Ive gone for the massage before and never had this problem. Ive taken some antiinflammatories but to no avail. This is the first time im experiencing such symptom. Is this something to worry about? Or an immediate appointment is necessary? Thank you for your advise.
Dr.Lou
Dear Dr Lou
Your symptoms are noted. It is not feasible to arrive at any diagnostic formulation based on the information given.
Before you consult a neurosurgeon, why not have a preliminary check-up by your family doctor, who would be in a position to evaluate and assess the need for specialist consultation.
Best wishes,
Webmaster
on behalf of Dr. Lee
Dear Dr Lee,
Good morning.
Last Jan 2016, i was diagnosed to (I’m not sure) cervical spondylitis or degeneration. Which effected C2-C7.
Last Oct 2016, i went to see a doctor without knowing him as a chiropractor. He twisted my neck in 4 different angles and over since i started to feel more awful and since then every time when i turn my head left and right, there are noises. And don’t really feel right. So i went to see my doctor in Sunway again and second MRI was done in beginning of Nov 2016.It seems it’s a bit worsen and the new problem is the base of skull is not in one piece. Not like what i see in my first MRI.
Everyday have discomfort from neck till fingers, and funny pain from shoulder, arm, elbow till fingers.
Always feel like to crack at point of my elbow and also fingers just to feel better for just a second.
I am thinking to go to see you at Sunway. Maybe go for another MRI if possible and hope can claim from insurance. Don’t know still can claim insurance because i did 2 MRI last year.
May i know, with my problem, can i take speedboat as i am thinking to go to Perhentian Island. 😦
Please advice.
Thank you very much for your time and hope to hear from you soon.
Warm regards,
Ai Lian.
Dear Ai Lian
You have listed a number of issues in your post. Given this limited information, it is uncertain what is the degree of your neck problem (if any). Thus it is not likely any appropriate advice could be formulated.
Do consider a proper consultation with the neurosurgeon to get a comprehensive assessment of your condition, and be advised what sporting activities are permissible.
Best wishes
Webmaster
Hi Dr. Lee,
i am suffered from serious synkinesis during the recovery of bell palsy, currently i can’t smile and blink my eye properly, may i ask is there any treatment for me? Thank you very much!
Nicole
Dear Nicole
It is not clear whether you still have residual paralysis of the facial muscles or indeed there are unwanted movements, i.e. synkinesis, which are caused by incorrect re-innervation.
Treatment depends on the actual causation.
Do consult your doctor about the appropriate treatment.
Best wishes,
Webmaster
Dear Dr. Lee,
I am aged 32 and have diagnosed that there is meningiomas in my right brain after MRI scan. The tumor protrude the skull bone, but did not implicate nerve tissue, and have no impact to me now.
Please advise is it necessary for me to go for a brain surgery to remove it? or I could have other options?
Dear YY
Your neurosurgeon would be able to advise on the necessity for surgery. There are many factors to consider, including size of the growth, its characteristics and whether there is any structure at risk in its vicinity.
Do consider a second opinion if in any doubt.
Best wishes.
Webmaster
on behalf of Dr Lee
Hello Dr. Lee,
My daughter is now 3 years old. She is suffering from delayed development. She does not have her neck control yet and can not sit independently. Doing physio, occupational and speech therapy.
Her development is very slow, but her other social activities are normal. Earlier at 8 months of her age she diagnosed with CMV and treated with medication.
At the age of 3/4 months she was as like as normal and roam on the bed, and also fall from the bed twice. At that time she had high fever and after that she became very calm.
Kindly seeking your valuable guide for her further treatment.
Best regards,
Rabby
Dear Rabby
From the info provided, your daughter is receiving all the modalities of treatment needed to maximise her recovery.
If you would like her to benefit from further medical expertise, referral to a developmental paediatrician is the next step.
Best wishes for your daughter’s future.
Webmaster
on behalf of Dr Lee
Thank you very much!
Dear Dr Lee,
I’ve hemifacial spasm few years ago, is no pain but recently the twitching become frequent, May I know any risk and side effect of microvascular decompression surgery?
Thank you Dr.
Dear M Ong
Risk-benefit discussion on any major form surgery needs to be conducted in a face to face consultation, taking into consideration the severity of the condition and the general health of the patient.
If you would like to explore this surgical option, do consider meeting up with the surgeon for detailed discussion.
Best wishes, Webmaster
Dear Dr Lee
I am 49 years of age and have been suffering migraine attacks for about 2 weeks. My right side of my head vibrates when i move or tilt my head. Had taken actifast, Fenagesic and even Avril to stop the pain but it comes back after 2-3 hours. The pain wakes me up every single day around 4am and it vibrates. i also realised that when i touched my neck on my right side, it is painful. What should i do.
Fyi, I’ve had a major ops sometime back in 2010 for L4/L5/S1 wherein i have 6 screws on my back. Am also in menopausal stage as well. Hope these info helps. Thanks.
Dear Michelle
If your diagnosis has been confirmed to be migraine, you should consult with your GP on the need to escalate from pain-killers to more specific medications for control of acute attacks. There are a number of choices for Level 2 medications.
As for back surgery, this is not likely to be relevant, unless it causes pain and discomfort which could provoke migraine.
Finally, migraines might indeed get worse during the hormonal fluxes of menopause. Managing the symptoms of menopause would definitely be helpful.
Best wishes, Webmaster
Replied by email
Dear Dr. Lee,
My name is Ally and I am from Penang. My father, aged 76 is suffering Trigeminal Neuralgia and currently is taking Carbamazepine. He has taken this medicine for many years, but now the medicine has no effect in reducing the pain any more.
I heard there is a surgery called “micro vascular decompression” can leads to permanent cure of Trigeminal Neuralgia. May I know how much will the surgery cost? Because my dad has high blood pressure, high cholesterol and he is also taking daily medicine for heart problem, can he takes the surgery?
Looking forward earliest response.
Thank you
Dear Ally,
Please refer to your reply sent via email.
Do you mind share me the information as about inquiry ?
Actually my mother in law, she is 61 year old and is suffering Trigeminal nerve, she had been took carbamazepine 2 months plus but have sign effect issue…. very worst….. now change to taking gabapentin but become skin allergic…..
She have diabetes and taking medicine, does she suitable to surgery micro vascular decompression ?
May i know how much is the charge ?
Thank you.
My friend has acoustic neuroma 2.1x 1.3x 1.1
Which specialist should he see ? Pls advise
Dear Madam Chan
Your friend should consult with neurosurgeon. She can contact Dr Lee at the addresses listed on this website.
Best wishes.
I am enquiring for my mother who is now in her advanced age of 88. She has been suffering from trigeminal neuralgia for more than a decade, and lately the pain has become unbearable. What would be the cost for MVD and if this surgery option is at all possible for her? Would you suggest gamma knife instead if MVD not recommended due to her age ?
Dear M Ooi
Treatment options for trigeminal neuralgia have to be tailored to the patient’s specific condition and general health.
Your mother should consult with the neurosurgeon to assess whether she has exhausted all medication options.
If indeed surgery is recommended, you will be guided on the merits of the various surgical techniques applicable in her case.
Hi Dr Lee, i have Lipoma (size 3cm) on my neck (right hand side) just below my chin…and because its near the neck and many nerve over the neck so i thinking of choosing Neurosurgery. Hope you can assist me with my problem.
Dear Mr Ho
Apologies for this late reply – your enquiry was caught by the filter. Indeed, the tumour may implicate nerve tissue or may itself arise from nerve tissue (e.g. nerve sheath tumour). Do contact Dr Lee to arrange for a consultation. If indicated, tests can be done to determine if nerve tissue is at risk.
Dear Dr Lee,
I was diagnosed with a DNET Brain Tumor in 2014 in my left temporal lobe. I am having blankness of my mind, loss my sense of thoughts and memory for few minutes everyday. I have done the brain surgery in 2014 but only part of the tumor can be removed as it is too close to the memory and speech area. I was taking Keppra till the maximum dose but still having seizures once or twice a week. Doctor was added Tegretol on top of it. My seizures was increased to around 20 times per day & i have stopped Tegretol. I have done my 2nd operation in 2016 after the MRI, EEG & Functional MRI. According to the Functional MRI result, there was 2 cm gap to the speech area and therefore i can choose not to be awaked during the brain surgery. However, based on the latest 2017 MRI scan, the tumor is still leftover around my speech area. Doctor suggested me to do 3rd operation & this time must be done awake. Should i try this awake operation in 2017 again as i am still having seizures nowadays & i am worrying it will still affect my speech in future if i choose not to do the operate now?
Thanks.
Dear Ms Jenn
Your situation requires detailed assessment of both your clinical status and imaging results. Do consult with Dr Chee at the addresses on this site.
Hi Dr. Lee Foo Chiang,
My aunt is 72yrs old and attacked by celebral aneurysm 3 days ago.
She is now in hospital.
Doctor advised brain surgery on her.
I would like to check what other options my aunt have now.
We are worried on brain surgery.
Dear Fei
You are advised to contact Dr Lee at the addresses provided on this site.
A detailed evaluation of the patient’s condition and pre-morbid health status is needed in order to formulate an appropriate treatment recommendation.
Best wishes,
Webmaster
Dear Dr. Lee,
I am 27 years old female and I have been suffering from Trigeminal Neuralgia (on the right side of my face CN V2). It started two years back and I was prescribed with prednisolone and some vitamins. I had no pain for one year in between but it came back a month ago. I again started the same medication few days back and the excruciating pain is not subsiding. I am looking for a permanent solution. I live in Bangladesh. Please suggest me the most beneficial but an economical option I can have so that it becomes easier for me to decide a visit at your Medical Centre. Thank you.
Regards,
Fariha
Dear Miss Fariha,
Trigeminal neuralgia can be treated satisfactorily with Microvascular decompression (MVD) which is a microneurosurgery. Long term complete relief of pain is expected in most cases after surgery. It is a safe operation that takes 90 minutes of operating time and about four days of hospitalization (includes ICU/HDU and normal ward).
Thank You.
Dr Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre / Beacon International Specialist Centre
Dear Dr Lee/Web Master,
How could I get a consultation on the costs for diagnosing TN and MDV treatment at your facility?
Dear Sham
Thank you for your enquiry. Costing for medical treatment needs to be individualised according to the patient’s condition and general medical status.
Do contact Dr Lee’s office at the address on this website and arrange for the patient to consult him.
Best wishes, Webmaster
Dear Dr. Foo-Chiang LEE
My daughter is suffering from spina bifida since birth. Is there any treatment that can cure his nervous system? whether stem cell treatment can cure it?
Below are quick medical records of my daughter:
MEDICAL RESUME
Sex: Female
Age: 7 years
diagnosis:
Spina bifida
Hydrocephalus on VP shunt
Post untethered cord 4 months
CDH pelvis sinistra
CTEV bilateral
Chronological course of the disease
32 weeks’ gestation: Hydrocephalus is diagnosed when the ANC, reconfirmed by USG Fetomaternal. When it has not detected spina bifida.
34 weeks’ gestation: it was decided for the termination of pregnancy through elective sc in the hospital, because based on serial ultrasound brain parenchyma are depleting. The existence became known as spina bifida at birth. My daughter was born with a birth weight of 1750g, with hydrocephalus, spina bifida, and bilateral CTEV.
Age 0 – ± 20 days: being treated in hospital. Minimum 1 day surgery hospital closed defect in the hospital, was not done earlier imaging studies, only blood tests.
In monitoring the size of head circumference showed a progressive, age 8 days a CT scan of the head (9/25/2009), aged 9 days to do the installation of VP Shunt.
Minimum ± 20 days: be patient.
Age 30 days: consulted the Orthopaedic, showed bilateral CTEV and their CDH left hip, pelvis radiograph done three positions (29/10/2009).
Ages 2 months – 1 year: Do spica casts installation action as much as ± 3-4 times, each 6-8 weeks, by 2 Orthopaedic different, but no improvement.
Ages 6 years and 11 months: action untethered cord in RS M, based on the results of routine MRI lumbosacral (08/03/2016).
Current complaints
– The nervous system is not perfect
o Both soles of the feet can not feel the stimulation
o BAB / BAK can not be controlled
– Condition of the bone
o CDH (dislocation) left hip
o bilateral CTEV
There are currently able to walk with the help of AFO shoes.
Dear Dicky
Spina bifida is a structural defect of the nervous system caused by development anomaly. Stem cell treatment is not indicated.
If you wish to have thorough reassessment of your daughter’s treatment by neurosurgeon, you are advised to have her undergo evaluation of her clinical status as well as her scan results.
Do consider arranging consultation with Dr Lee Foo Chiang at the contacts listed on this site.
Best wishes,
Webmaster
Dr.Lee Foo Chiang,
I have 4.5*3.5*5 cm midline non-communicating posterior fossa arachnoid cyst that is per Dr assessment of CT scan eroding the occipital bone and constant pressure on cerebellum and No hydrocephalus. My main symptoms are breathing difficulty, head ache and left eye and ear pain. I have good ekg , stress test results and exercise regularly inn gym, though am slightly overweight at(5.7 ht 80 kg wt).
I do not find any good articles in the web demonstrating Malaysia capability and experience in endoscopic fenestration and treatment. I live in Indonesia and I have opted to either treat myself in Malaysia or india. Can you shed guidance on what facilities and expertise are available for this treatment. Per Dr assessment, I would be better off with surgery as any trivial fall can lead to emergency, Although I feel if breathing, overall CSF circulation and pain improves that is worth taking the risk of this complex surgery.
Dear Rob
Even though endoscopic fenestration may sound less invasive, it has a significant reclosure rate of the openings created as compared to microsurgical excision of the cyst wall which is a definitive treatment with long term cure.
Thank you
Dr Lee Foo Chiang
MBBS FRACS ( Neurosurgery)
Consultant Neurosurgeon
Greetings Dr,
My father is suffering from severe back pain due to the following reasons from his MRI report:
1) Circumferential disc prolapsed at L4/L5 with left inferior posterior disc herniation. Moderate compression of right side caude equina
2) Posterior L5/S1 disc prolapsed. Mild compression of caude equina (the L4/L5 disc prolapsed has increased in severity)
I wish to find out the best treatment for this problem.
Thank you
Shan
Dear Shan
Every case is unique. Your father needs a thorough assessment of his lumbar spine as well as his general health, followed by study of the MRI findings, in order to arrive at an appropriate treatment recommendation.
Do get a proper clinical evaluation for your father.
Best wishes,
Webmaster on behalf of Dr Lee Foo Chiang
Dear Dr Lee,
I have trigeminal neuralgia pain a few month ago, i taken medician Nuerontin Gabapentin 300mg, but somtime still cannot control the painful, may i need to have gamma knife treatment for my trigeminal neuralgia?Thank You
Dear Miss Syn Yee,
While Gammaknife radiosurgery is an option for treatment of Trigeminal Neuralgia, it’s beneficial effect is delayed (4-6 weeks) and unpredictable compared to Microvascular decompression (MVD) which is well proven with long term cure without the radiation side effect of Gammaknife.
Thank you.
Dr Lee Foo Chiang
MBBS, FRACS ( Neurosurgery)
Consultant Neurosurgeon
Dear Dr Lee,
My mum has recurrent brain tumors on the side where she had gammaknife therapy months ago. May I ask could I send you some photos to ask your advice about the best treatment she could have to remove the tumors? If so, may you reply to my email and then I can send you some MRI photos? I will tell you more about the details there too.
Thank you very much.
Dear Ms Tiffany
Recurrent brain tumour is a difficult and complex situation. This requires assessment of clinical as well as imaging data in order to formulate appropriate treatment recommendations.
Do consult with Dr Lee for advice.
Best wishes,
Webmaster
Hi Dr Lee,
I had a head operation 4 years back. It was due to sudden fell at home which caused blood clot in the brain. The operation went well. The thing is after time , the small pieces of skull cut from the first operation seems to be sinking over time. 3 weeks ago, the screw was appeared out of the skin. Few days later, the screw seems disappeared again.
Appreciate your advice on this.
Thank you.
Dear M Ling
You need a clinical assessment to determine the status of your skull bone and whether there is any protrusion of the screw. Your GP would be able to check this out. Alternatively, you may consult the Neurosurgery Department where your operation was performed.
Best wishes, Webmaster
Dear DR. LEE,
My father fell down from a staircase and his head swollen. After government hospital checked, there is no internal bleeding therefore they let him discharged after few hours observation. After come back home he vomitted~ I would like to know whether this is normal and how long should we observe before sending him to neuro surgeon? He is 60yrs old+
Dear Ying
Vomiting after head impact may be due to pain, indigestion or other some other benign cause.
However, it could indicate worsening of your father’s brain injury.
You are therefore advised to refer back to his hospital for further assessment.
Best wishes, Webmaster
My girl friend herpes 2in her virginity.doctor in jakarta check herblood test conform she has herpes2.my question is .is there a clinic in johor bahrugot a treatment for herpes .
Dear Anuar
We are not familiar with the clinical services in Johor Baru. You need to look for a specialist in Genitourinary Medicine.
Best wishes, Webmaster
Dear Dr. Lee.
My 9 year old nephew is diagnosed having brain tumour by local neurologist, and her mom is planning to consult with Malaysian specialist and decide the necessary according to diagnosis. To be more certain, and to clear all worries and doubt, would you be your comments by looking at this image https://goo.gl/photos/oTwhcRocJ2MUgyyCA and this analysis https://goo.gl/photos/27J7GtkAauyUPCXk6 . Thank you in advance.
Dear M Liong
This cerebellar tumor is quite amenable to surgical resection.
The parents may arrange for the child to see me in Sunway Medical Centre as soon as possible.
Thank you.
Yours Truly
Dr Lee Foo Chiang
Consultant Neurosurgeon
dear doctor, good morning. i am sharanjit kaur, 35 year old woman from kl. since May, i knew i am some problem with my eyes, at the same time i went into very stress mode and fear, then i started realizing from my hips till my toes, i was vibrating from inside. beneath my toe it was poking slightly, but now its like my feet is in constant buzzing mode and my legs have this crunchy feeling (electric current) when i hit my back above my buttocks, there is like current movement throughout the legs. when i lie straight, at times the nerve will have pulling sensation. my finger tips do have some numbness too.
I went to visit the neurologist in island hospital, did MRI (slight bulge which Dr said is normal), nerve test, blood test, all tests came out good God bless. the conclusion the dr said is I’m too stress. my mind wants to belief, yet my heart is fearful, i am doing acupuncture, taking neurobian and Ginkgo Baloba. please advice what is your expert opinion. Thank you.
Dear Ms Sharan
From the info provided, the necessary tests have been preformed, with the results being negative.
Do consult your doctor if you are still unwell. If it is concluded that you are suffering from stress / anxiety, you can be referred for appropriate treatment which might involve stress management programme, relaxation therapy, talk therapy or medications.
Best wishes, Webmaster
Dear Dr Lee
My son is a former 25 week gestation male, born on the 14th of April 2011, with a history of bilateral intraventricular hemorrhage (IVH) (grade III right, garde IV left) with 99 days in the Neonatal Intensive Care Unit, . His most recent CT showed left sided periventicular mild leukomalacia . He had delayed onset of ambulation (at 2years) with persistent toe walking and an inability to jump initially. He has no history of regression or development delay in other domains. At the age of 3, he was evaluated in the USA by a neurologist and physiotherapist. His neurological exam is significant for microcephaly, yet proportionate to other growth parameters. He has a decreased range of motion at the right ankle, increased reflexes on the right side and bilateral toe walking ( more prominent on the right ) with slight circumduction of the right leg. The physiotherapist assessment recommended physiotherapy and orthotic shoes. He has been wearing the orthotic shoes and undergoing physiotherapy sessions in Oman ever since. He is being follow up by orthopedics in Oman to date. On the 17th of January 2016 a lower limb x-ray showed no limb length discrepancy . He is currently 5 years and 2 months of age, he can walk and run normally and active at school but at his toe, he can jump slightly. The orthopedic Consultant in Oman feels the physiotherapy and Orthotic shoes were ineffective in treating his gait problem. Hence they are recommending Botex injections RT CALF.
Can you please give us an advice ?
Dear M Nabil
Thank you for your enquiry. The expert recommendations provided for your son by your Orthopaedic Consultant are entirely in keeping with best practices. Do please proceed as advised, since he is not likely to require neurosurgical intervention at this stage.
Webmaster
on behalf of Dr LEE Foo Chiang
Dear Dr. Lee,
My mom, 85, just got an MRI on her lumber because of her back back in Subang Jaya Medical center. The report impression show that the L3 vertebral body lesion if possibly hemangioma or Intraosseous lipoma. I am wondering you have any recommendation for path forward? Do you see patient with this kind of condition.
My mom has a history of ovary cancer and her ovary was completed removed almost 30.
Concern Son.
Dear KC
The MRI finding needs to be correlated with the clinical condition of your Mother in order to arrive at a appropriate therapeutic recommendation as to whether any action is needed, and if so which form it takes.
Do consider bringing her to see Dr Lee at the contacts listed at this site.
Best regards,
Webmaster
my dad is 72 years old, all normal, due to some research conducted by phd team on dimentia, they approached him for dimentia check in senior library, and they hadfree mri,he went for mri, not recommended by family doctor.
and mri report came yesterday.saying
along the midline and left paramidline cerebellum posteriorly. there is oval extra axial, arachnoid cyst that measures 3.6cm x 2.8 cm ap on axial flair sequence image 4/20.this cyst exerts mass effect upon the left posterior cerebellum, and compresses the inferior margin of the 4th ventricle. there is 9 mm of downward herniation on right cerebellar tonsil, below the foramen magnum.left celebellar tonsil is in normal position.
moderate enlargemnet of the cerebral ventricles.with respect to normal size cerebral sulci.
there is no intra-axial edema or midline shift of falx cerebri..there is no while matter lesions
7th and 8th nerve complexes and pituitary fossa are normal
there is no subdual and epidural hermatomas of fluid collection.
Question is…….
he is diabetic, fit and sound, walks for 1 hour everyday and he is on his own…no symthoms as i read online..
i am confused.he is fit and sound, he has to go any shunt surgery…for removal of fluid…or keep as it is…since we have no symptoms….pls guide me i am worried for him…
did we did mistake of doing mri….
Dear Era
Your father needs to be assessed as to whether the MRI findings are relevant or not, and if so, whether surgery is appropriate.
Therefore, a thorough clinical-radiological correlation is needed.
If in doubt, do consider a consultation with the neurosurgeon.
Webmaster
Dear Dr.Lee,
On 28.jan.15 I undergo MRI LUMBOSACRAL SPINE which resulted :
The lumbar vertebral bodies and end plates are normal.
The lumbar spine shows normal alignment and curvature.
There is a mild posterior bulge of the L4/L5 disc. Otherwise, the intervertebral disc are in their normal locations and return normal signal.
The spinal cord is normal in appearance, returns normal signal and ends normally at the level of T12/L1.
There are 2 Tarlov perineural cyst seen – one at the level of S2 measuring 1.8cm x 1.5cm and another at the level of S3 measuring 1.5cm x 1.1cm.
The axial sections at L4/L5 reveal that there is a diffuse posterior disc bulge. No spinal canal stenosis. There are bilateral neural exit foramina hypertrophy or facet joint disease seen.
The axial sections at L3/L4 and L5/S1 reveal that there is no disc prolapse/bulge. No spinal canal atenoses or neural exit foramina narrowing. The exiting and traversing nerve roots are not compressed. No ligamentum flavum hypertrophy or facet joint disease seen.
Question:
1. What should i do?taking medicine or fisio?or any advice?
2. Recently i always feel tired, back pain whenever i sit too long,bend my back or standing too long.if i lying down or sleep the pain is less or gone.
3. I didnt take any medicine nor supplement currently.the last doctor gave me pain killer only.aftef that i didnt take any.
4. Should I do again the MRI?
Appreciate your reply in return with thanks.
Regards,
Mariyana
Dear Mariyana
In order to provide proper medical advice on your condition, a thorough evaluation of your clinical status and scan images is necessary. You are advised to consult your doctor for your further management, as to whether it should be medications, physiotherapy, or any other modality of treatment.
Best wishes,
Webmaster
Dear Dr Foo,
We just found out that my mom had tumor in her head, between brain and skull. We had PET Scan and CT SCAN.
If surgery procedure is a must, what’s the low risk on procedure? As this is the top concern of us. I have the result of both test.
Please advise.
I can be reached via Whatsapp +628121080465.
Sincerely,
Christine
Dear Christine
Your Mother needs a thorough assessment of her clinical status as well as the scans in order to arrive at a proper recommendation on treatment choices for tumour.
Do consider a consultation with Dr Foo Chiang Lee at the contacts listed on this site.
Best wishes,
Webmaster
on behalf of Dr Lee
Dear Dr Lee,
I have a tingling and pricking sensation near the jaw area for past few weeks. I had consulted a GP and was told to have peripheral neuropathy which required no treatment. I would like to seek your advice and recommendation on my condition. Appreciate your reply the soonest possible. Thank you
Dear Poh
It is unusual to have the jaw area affected in typical cases of peripheral neuropathy.
The sensation may well disappear if it is due to muscle strain, stress or other self-limited condition. Do consult your GP again if it does not resolve.
Best wishes,
Webmaster
Dear Dr. Lee,
My father has these syndromes (speech impairment, headache, insomnia, balance problem – easily fall down and problem getting up). He had visited many doctors in Indonesia, mostly neurologist, cardiologist, also some internists, performed many lab tests and several CT Scan, and Colored CT Scan. However there has been no definitive diagnosis of the real problem from all the visit. Do you have any possible ideas and do you think it is a good idea to visit you in KL for consultation.
Thanks,
Ian
Dear Ian
It is not possible to make a diagnosis from the limited info available. One may hazard a guess that this could be a form of Parkinsonian Syndrome.
Unfortunately, not all of these conditions have effective treatment other than balance therapy through physio, and medications for symptom relief.
A consultation is needed to arrive at an accurate diagnosis.
Best wishes.
Webmaster
Dear Dr.Lee
My brother-in-law was diagnosed with Parkinson. His drug prescription is 200mg of stalevo taken 5 times per day and 1.5mg of pramipexole DIHCL one tablet per day only. The problem is the trembling only stop one and half hour after taking the drugs and later two hours later the trembling come back again. Is it normal?
Regards.
Dear Lily
Your brother-in-law is taking two of the latest and more efficacious drugs for Parkinson’s disease.
Dosage is guided by the patient’s response and must be tailored to the individual’s needs. He should refer to his doctor for measures to improve his status.
Best wishes.
Webmaster
Dear Dr Lee,
I’m diagnosed with Syringo Myelia in 2007 with C4-C5 affected. In a scan during 2009, it was captured for C3-C7. After then till now, I have not done any MRI scans to further check. May I know what are the best option I should take and if there’s surgery involved, what kind of surgery and are the surgery high risks and what are the costs of the surgery?
Thanks a lot.
Dear Dennis
You are advised to consult your neurosurgeon on the necessity for follow up MRI scans. If scanning is needed, then advice would be based on the scan results.
Best wishes.
Webmaster
Dear Dr. Lee,
My Dad has been diagnosed with nerve cancer this year and he is now at stage 4. He refused to tell me the details about it. But as far as I know he vomitted blood instead of bursting at brain. His doctor claimed it was a miracle for him to vomitted blood as it was supposed to be burst out at his brain. I am wondering how much does it cost for the surgery and what is your recommendation Dr Lee regarding on my father’s case? Looking forward to your feedback regarding on this matter.
Dear Shahirah
We are sorry to hear of this distressing disease. It is not possible to give any treatment guidance, let alone the costs, given this limited information. Why not discuss with your father what are his wishes, and then consult his doctor about the treatment options and costs. Once these have been ascertained, we are happy to offer suggestions.
Webmaster
Dear Dr Lee,
I’m a mother of 10/12 old boy which is suffer from underlying hypoxic ischemic encephalopathy grade 3, SAH, congenital pneumonia due to birth delay at GH. My son been treated in GH since he was born for now only supportive treatment. Hospitalizations for 5 times due to same problem lung infection. He now is having global developmental delay, localised seizure ( on neurotine, pyridoxine, epilim and keppra), dystonia (benzhexol, chlorohydrate), bulbar dysfunction(glychopyrorate), gerd (maxolon, omeperazole), eeg done shows generalized seizure. I’m seeking another hope for my son as he is a survivor in fighting his disease. I as a mother never give up in giving hope. I wanna enquiry about any other option to make him recover and independent in future (avoid from been ▲ CP). I knew got stem cell treatment. Is he indication for it? If so, how much is the costs and the prognosis? I’m from kelantan.
Regards,
Ms.tee
Dear Ms Tee
Your child is receiving up-to-date therapy for hypoxic ischemic encephalopathy (HIE). You are worried he may develop cerebral palsy (CP).
If so, then what are his options? Stem cells are under intensive investigation for CP caused by HIE and other brain insults. However, progress is slow, as the brain is a very complex organ system (with “hardware” and “software” portions) to repair. Reproduced below is our previous response on this topic:
“Stem cell treatment is not yet approved for treatment of cerebral palsy. This paper http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057381/ summarises the state of our knowledge, including lack of proven benefit and risks of treatment. The conclusion of the paper is below:
Current clinical trials in the use of stem cells for cerebral palsy are on-going and incomplete. While there are a number of different cell types that are potential candidates as treatments, none have been shown to be effective in chronic animal models. Furthermore, available animal models do not adequately mimic cerebral palsy. Risks of the treatment are reported. More work on understanding the underlying beneficial biology of stem cells and the development and validation of more relevant animal models is required.
Research centres are listed in the paper.”
Finally, combination of parental love and medical support has enabled many children like yours to overcome tremendous hurdles and go on to lead meaningful lives.
Best wishes.
Hello Dr.Lee.Im 20 years old male having severe trigeminal nuralgia.Im on tegretol 1200mg not helping me much on the pain and its making me drowsy all the time effecting my daily life.I did an mri which shows “right superior cerebellar artery is seen to indent upon distal cisternal segment of the right trigeminal nerve causing inferior deviation and thinning of the nerve at the point of contact -suggestive of a vascular loop.”.Now drs here are giving me 2 options either gamma knife therapy or MVD.Im aware that you are dong MVD and the success rate is high.Can i know the total cost of the surgery,duration of surgery and the duration of hopitalization neededtq.hope to hear soon.
Dear Kumar
Sorry to hear that you are suffering from severe trigeminal neuralgia at an unusually young age.
Do consider making appointment to speak with Dr Lee before you make any decision.
There are a number of other effective medications for neuropathic pain other than Tegretol.
Both surgery and gamma knife radiosurgery are major undertakings in terms of medical risks and costs, hence you should exhaust lesser options before embarking on them.
Best wishes.
Webmaster
Dear Dr Lee,
Appreciate your advise on my mother’s case. She’s 65 years old this year. Her health has been in good condition except for a pain that always strike on the nerve of her head. She told us that it was as if a sharp pain felt in her head when she bites or when she washed her face. When in contact with water, when washing her face, her head will have this feeling of ‘electrical shock’. We went to the general hospital and did a scan few years ago. The report shows all right. However the pain is still there until now.
Recently, she can’t bear with the pain and she’s not been eating much, since munching will caused her nerve to be in pain too. She has been losing weight and even had gastric pain now. We are very worried and was wondering if what types of scan that she can do to check further on her issues? Shall she consult a neurologist? Thanks
Dear Fenn
From the information provided, it may be speculated that the pain is due to trigeminal neuralgia. Do request for referral to see neurologist for the appropriate treatment.
Best wishes, Webmaster
Hi Dr Lee,
I’m having a herniated disc on my L4/L5. My back muscle feeling cramp and right leg having pain. Sometime the pain go until the toe. Nowadays, I feel my toe when trying to push up has no energy. When I sleep, I can’t sleep well. I’m not able to get a right position which feel no pain. Currently I’m using pain killer to control my situation.
I did when to physio and swimming more than 6months but I feel not much progress. Do you recommand me to do Microdiscectomy Spine surgery? Do you think it helps my situation?
Is this kind of surgery is low or high risk surgery? Please advice.
Dear Winnie
Back pain is a multi-faceted condition. The pain could arise from any or all of these spine components: bone, disc, ligament, joint, muscle, and tendon, together with super-added stress and strain (both physical and mental).
You need a comprehensive evaluation, after which surgery may or may not be deemed to be appropriate.
Do speak with your spine specialist. Alternatively, you could consult with Dr Lee at the contacts on this website.
Best wishes for recovery.
Webmaster
Dear Dr Lee,
I am MS Chooi. My dad undergone a brain surgery and followed by tracheostomy surgery back in November 2015. He is 83 year old now. He is able to walk with minimum surpervision by now, but we suspected his memory is not fully recovered yet as he only can recognize my mum. However, he failed the swallowing test after a couple of follow up visit in KL hospital. Would appreciate your advice on how to improve his swallowing ability ? will swallowing therapy helps ? If yes, do you provide such services. If no, could you recommend a good therapist.
Thank you.
Ms Chooi
Dear Ms Chooi,
Super seniors like your Dad will require much longer time to recover from major surgery like craniotomy. There is also high risk of complications such as confusion and swallowing problem (which may occur even in the well elderly BTW). The speech and swallowing therapist will advise on appropriate jaw and oral exercises. Improvement may take weeks or months. In the interim, nasogastric tube feeding may be offered. If deemed to be permanent, Percutaneous Endoscopic Gastrostomy (PEG) will be needed for long term feeding.
Dear Dr Lee,
I had a right eye inflammation last October 2015 and then the inflammation was cured by a medicine called Nevanac but then I started getting a stinging sensation just above the right eye near the eye brows. There were some rashes n after applying the fucidin cream..the rashes went off…but the stinging sensation was still there. The doc concluded it was a herpes zoster attack and put me on Valtrex. Now it has been 3 months since then and I don’t get any stinging sensation anymore..the eye is back normal..but I still have a sensation feeling around the right side just above the eye until d back of the ear. Looks like the nerve is causing it..what is your advise doc?Thank you.
Dear Jit
You need to consult your doctor whether the herpes zoster attack is confirmed to have healed, and to manage any leftover symptoms. Mild discomfort may be felt after healing of shingles but more persistent pain needs your doctor’s attention.
Best wishes, Webmaster
Thanks doctor, appreciate your advice here.
Dear Dr. Lee
I am female and 42 years old. I have just finished a MRI test in last month due to sudden attack by hand and leg stiffness during driving and report mentioned that my pituitary gland appears enlarge and there is suprasellar extension. It measures 13 x 9 x 9mm. (Pituitary macroadenoma) Besides that a small retention cyst is seen in the left maxillary antrum measuring 4 x 9mm. I have been advised that I need to go for surgeon if pituitary gland growing in my next MRI test in July otherwise I will have visibility problem with my eyes.Currently I have been given a medicine Hydrocortisone tablet 10mg for daily intake till next MRI.
I wish to have 2nd doctor opinion for my condition because I wish to have others solution apart of surgeon required later.
I can seek for your treatment and advise in Sunway if you are interest to see my MRI film and report by face to face.
Look forward your soonest reply, thanks.
Dear Miss Evon,
Feel free to call my office at Sunway Medical Centre 603-74919777 Miss Rose for an early appointment.
Thank you.
Dr. Lee Foo Chiang
MBBS, FRACS ( Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre/ Beacon Int Specialist Centre
Dear doc,
I have a close desperate friend who has a son of 25 years old with the following symptoms. His son is suffering from an acute migraine since one month and is on sick leave….. All tests (CT scan, MRI, MRA, EEG…)performed so far show no issues; yet the pain is constant, 24/24 hr with at least 2 daily acute strokes on head/brain leading to loss of memory, loss of vision, numbness…
All Neurology Doctors still cannot find a solution…..
Also consulting a Psycholoque and Hypno-Therapeute…..
Any advice will be welcomed as parents do not know what to do with their son’s state
Thanks you beforehand
Gaetan
Dear Gaetan
Your friend’s son does not appear to have a lesion which requires neurosurgery. The treatment of severe migraine consists of anti-migraine medications, relaxation and psychological management of all contributing stress factors.
Best wishes,
Webmaster, on behalf of Dr Lee
Dear Dr. Lee, my father (age of 72) was admitted to hospital for 4 days on 3 December 2015 due to stroke attack. It was caused by a blood vessel in the brain bursts (2cm). The doctor also discovered ‘bone disorder’ on his skull. Now, the doctor is asking him to do the contra CT Scan where they will inject the liquid into his body for the CT Scan. It seems the liquid is very harmful to the body, such as it might cause kidney failure, some even has breathing difficulty, itchiness etc.
Would like get our advise on this CONTRA CT SCAN whether It is safe for a elderly person like my father to do??? Other than contra CT scan, is there anyway we can do any other type of scan that are safer??? Please advise
Dear Kee
Constrast injection is a routine procedure in CT scanning techniques. The Radiologist who is in charge of CT scanner in your hospital is responsible for ensuring safety of the procedure. This specialist is unlikely to put your father at risk. Do ask for a discussion with this doctor about your concerns before the planned CT scan.
Webmaster, on behalf of Dr Lee
Good noon Dr thnxs for your kind attention,
My son is 22 this year doing his Engineering course here in K-Lumpur,
Maybe its stress related ,
Thanks alot Dr ,
Dear Dr.,
My son is complaining of frequent severe headaches. He have done CT Scans but doctors could not detect anything. What can you suggest Dr. , I suppose he needs to go through more thorough or specific test to check if there are any tumors or any other probelm. Please reply to my e-mail directly meeranir@yahoo.com
Dear Sharan
Your son’s age is not provided. In general, brain tumour is unlikely when the CT scan is normal.
Depending on his age, you should consult the paediatrician or family doctor as to the possibility of other causes of headache. These include medical illness, infection (e.g. sinusitis), migraine and stress (tension) headache.
Best wishes.
Webmaster, on behalf of Dr Lee
Doctor, my wife having Thyroid Cyst symptom. Was there other way to cure other than having surgery ? I leave in Penang. Any recommendation treatment center that I can get advise in person as well ?
Dear Mr Lee
We are specialists in Neuro conditions. Do consult with your surgeon if you need an in-depth understanding about the treatment options. Your GP would be in a position to recommend another surgeon in Penang.
Best wishes, Webmaster
Dear Dr Lee,
What is your opinion on Tarlov Cyst?
Dear Ms Punitha
Your enquiry is too brief for us to offer any meaningful advice. We’ll try to help if more details are provided.
Best wishes, Webmaster
Hi Dr.Lee,
Would like to know whether you have done
is micro vascular decompression (MVD) before? I stay in Batam (indonesia) ,and being diagnosed to have HFS. Base on research and your above comment definitive treatment
is having MVD, hence would like your advise on the following :
1. Whether your clinic have perform MVD and what is the success rate?
2. Any recommendation on MVD surgeon in Johor (which nearer to Batam)?
3, What will be the cost to have MVD surgery in Malaysia?
Thanks
Dear Nico,
MVD for hemifacial spasm has been done by me in Sunway Medical Centre with excellent results, since 1999, and in my earlier practice since 1985. Currently total cost of surgical treatment is Rm 55-65K. This includes hospital charges as well.
You may contact my office at Sunway MedicaL Centre 603- 73019777 Miss Rose for a consultation appointment.
Thank you.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Doctor, my sister’s new born baby has diagnosed with meningitis. He is in ICU for two weeks already. Even though several antibiotics was given, but still got fever. What can we do now? We really need yours advise.Thanks.
Dear Ms Ng
Meningitis in the newborn is a complex and serious condition. ICU support together with effective antibiotics are indeed part of best practices. Do consult with the infant’s doctors if you need information and explanation regarding the patient’s status.
Best wishes.
Webmaster
My baby boy suffered frm myelomeningocele at birth (only detected right after birth). He already went for operation (at 1mth old) to removed that excess sack at private hospital. But, after couple of days of operation (after discharged frm hospital) we noticed there’s a lil bit of liquid came out frm the stitch wound. During followed up check up, his neurosurgeon said it’s the CSF leakage, minor one. He prescribed us with antibiotics for further 10 days until next follow up appointment.He told us, that the wound still not heal 100 % and as time goes by, the wound will heal and the leakage will stop. So far, there’s no sign of hydrocephalus (touch wood). What’s ur advice doc?..really need 2nd opinion… Thx in advance…God Bless..
Dear Dean
From the information provided, it looks like your child is receiving all necessary and appropriate treatment. Do speak with the specialist about your on-going concerns.
Best wishes, Webmaster
Dear Dr Lee,
I have been suffering with hemifacial spasm from last 2 years. I’m 32yrs, female. Been referring to neurologist in one of the private hosp in KL. Now he prescribed me with Espran to minimize the symptoms, before we go for Botox. This hemifacial spasm really annoying and disturbing, make me lose focus with my work and effect my interaction with people. May i know how much is the cost for the micro vascular decompression operation? Do any private hosp in KL perform this operation? I prefer permanent solution rather than temporary relief.
Dear Miss Mel
The definitive treatment for hemi facial spasm is by micro neurosurgery operation Microvascular decompression (MVD).
This is a safe surgery and leads to long term cure if done by experienced neurosurgeon.
Thank You
Yours Truly.
Dr. Lee Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre / Beacon Int Specialist Centre.
Tel: 03-74910777
or 03 7787 2913
Dear Doctor,
My name is Lim. I have a severe case of eye and facial twitching on my right side. I have done MRI and found nothing wrong. Other doctors suggested for Botox injection to overcome this problem. Now it seem it is only a temporary solution. Please advise me on what to do to resolve it permanently. Hope you can assist me with my problem.
Thank you
Dear Miss Lim
The definitive treatment for hemi facial spasm is by micro neurosurgery operation Microvascular decompression (MVD).
This is a safe surgery and leads to long term cure if done by experienced neurosurgeon.
Thank You
Yours Truly.
Dr. Lee Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre / Beacon Int Specialist Centre.
Tel: 03-74910777
or 03 7787 2913
Dear Dr. Lee,
My sister’s baby 10mths currently in Kuching Sarawak. Last week had do the brain tumor operation. The Government Doctor suspect is AT/RT Tumor.
Now still under discussion how to do the treatment. May i know baby suitable do chemotherapy or Radiotherapy?
Dear Miss Ivy,
It is not easy to advise you based on the very limited informations you provided about the 10 month old baby. Is it possible for you to forward the MRI brain report as well as histopathology report of the tumor?
Thank you.
Regards.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
Sunway Med Centre/ Beacon Int Specialist Centre
Dear Dr. Lee,
For nearly 2 weeks, I have been having this small but irritating pain on the top back of my head (right side to be specific). Is not a headache or migraine. Is not a bump or swollen. I didn’t fall down or bump my head. The pain is like a pregnant lady having a contraction pain. It comes and go every 1-2 minutes. I suspect it could be my nerves. I am not sure.
Please advise.
Thank you in advance.
Dear Jaime
The info provided is insufficient to come to a conclusion about the cause of the headache. If the pain persists, you are advised to consult your family doctor.
Besides migraine, possible causes include heat/humidity, lack of sleep, muscle strain and medical conditions.
Best wishes.
Webmaster
on behalf of Dr Lee
Dear Dr. Lee,
for the past few months i notice that my left upper lift has dropped at least 1/2 cm and my jaw bone is moving to the left side when i talk. i’ve been doing alot of reading and not sure if i’m having bell’s palsy, hemifacial spasm or facial paralysis thus seeking advise on what should i do next.
Dear Morgan
It is possible from your description that you might have weakness of either the facial or the jaw muscles on one side. Hemifacial spasm on the other hand causes the muscles to be actively pulled to the same (ipsilateral) side.
Please do consult your GP for an initial assessment and guidance on the appropriate treatment.
Webmaster
on behalf of Dr Lee
Hi Doctor, my son currently having Hemifacial spasm for years. We have consult a lot of doctors and their best treatment is Botulinum toxin injections which has to be done regularly for 3-6 months. My son is now 20 years old, is there any long term cure or treatment which does not require short time reliefs?
Dear Ms Susan,
The definitive treatment for hemifacial spasm is micro vascular decompression (MVD) which involves micro surgery. When done by experienced neurosurgeon this is a safe operation which leads to immediate relief of the hemifacial spasm. This operation was first introduced in the late 70s and popularised in the 80s by Dr Peter Janetta of USA and would have been the first treatment of choice before BOTOX was invented. Botox is useful in the early phase and as an interim measure. It has to be repeated every 4-6 months and there is a possibility of treatment failure if the body develops antibodies against Botulinum toxin.
Thank You.
Dr Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre / Beacon Int Specialist Centre.
Hi Dr. Lee,
This is Majid and I would like to discuss the case of my niece, now she is in Pakistan. The history overview is as under:
She was born a normal child weighing 3.3 kg’s at birth. Her parents are inter family married. The first incident which she had, was falling from a height of 14′ feet, she was just an age of 10 months old at that time. She had her tests which were cleared and was deemed fine by the doctor at that time. As she grew, her speech was not clear as a healthy perfect growing child, she merely spoke very few unclear words. In the meantime, we consulted few speech therapists, and were advised for here IQ, which we did, and was summarized as,
“Syeda Zainab Ali is 3.5 years old and was brought for her IQ/psycho diagnostic evaluation. Due to her limited speech formal IQ test couldn’t be administered, however informal observation suggested here LOW intellectual potentials. Reassessment of intelligence was recommended after one or two to know the exact range of IQ. An adaptive behavior (social IQ) seems to be low from her current age level. Her maturity and sensibility level regarding performing personal, domestic and daily tasks and making meaningful relationships, maybe swung between 11 months to 3 years old child”.
Then we were advised to see a pediatric neurologist. We were advised for further tests (which included EEG and Blood Test). Then she suffered a very high fever, her seizure’s followed a week after. She was again taken to a neurologist who advised for further test (MRI and Blood Tests). She was under medications for seizure’s, during this time. She then went to Iran Where she fell ill and became very weak from then till now, she is unable to walk properly. The duration and frequency of seizures has also increased. The neurologists have advised us to see a genetic specialist and this is latest step in her medical history till now.
On the meeting with the genetic specialist, we were advised to get the opinion from the doctors (Neurologist of Malaysia). Therefore, we are contacting you and I, undersigned her uncle is here at Kuala Lumpur, all the reports are available as soft and hard copy. Further, I can see you on your available time.
Looking forward for your positive and earliest response.
Best Regard,
Majid
H/P: (+60) 10 263 4462
Dear Mr Majid
Thank you for your enquiry. We note your concern for your young relative. For info, Dr Lee is a neurosurgeon.
This child needs to be managed by paediatric neurologist, who will request any relevant genetic studies.
You are advised to consult the specialists in University of Malaya Medical Centre for such expertise.
Best wishes,
Webmaster, on behalf of Dr Lee Foo Chiang
Dear Ms Pei
It is not possible to speculate as to what might be causing your friend’s problem without adequate medical information about the operative procedure and his clinical findings. He could request his doctors to refer to the appropriate specialist.
Best wishes, Webmaster
Hi Dr Lee,
My friend’s sister are being diagnos and discover that she has blood vessel blockage at her brain. They got consulted a couple doctor and the feedback was that the changes are less than 10%. What’s your advise and would you recommend any good neurologist that they can refer to or perhaps you yourself can help out.
Dear Mr Cliff,
We need to assess the severity of the brain blood vessel narrowing and whether she is symptomatic from this. MR Angio with perfusion studies will be helpful. Do bring along these tests and scans when she sees a neurologist or neurosurgeon.
You may want to consult Senior Consultant Neurologist Dr Lee Moon Keen or myself at Sunway Medical Centre.
Thank you.
Yours Truly.
Dr Lee Foo Chiang
Consultant Neurosurgeon.
Sunway Medical Centre / Beacon ISC
Dear Dr Lee,
i have been suffering from HMS over the past 4 years. i had 3 botox injection done within that period but i understand that the effect will eventually wear off and resistance might set in. In your opinion is it advisable to have MVD surgery done? any medical complications post surgery? and how long does it take for one to fully be recuperated and be able to resume daily work?
thanks!!
Dear Darren,
Micro vascular decompression ( MVD) offers definitive, immediate and long term relief of hemifacial spasm. It is a safe micro neurosurgery if done by experienced neurosurgeons. The only possible morbidity if it occurs is hearing loss on the same side but this can be avoided by doing intraoperative brain stem auditory potential (BAEP) recording.
After 4-7 days of hospital stay, you can anticipate to resume work after another 1-2 weeks.
Thank You.
Dr. Lee Foo Chiang
Consultant Neurosurgeon.
Sunway Medical Centre / Beacon ISC
Hi Dr. Lee,
Appreciate if you can give me some idea roughly how much is the charges the gore from the brain?
It was happen to my uncle last 2 week he had suddenly fainted and injured his face. Then he went to UM for check up and did his MRI test. After the result it showed my uncle brain have bleeding sign which need to remove all the gore urgently.
My uncle stay a bit far from Sunway therefore we would like to know roughly how much of the charges so that at least he can prepare it and did the operation as soon as possible.
I got all the report with me if you would like to see it i can email to you.
Waiting for your good news and reply.
Thank You and have a nice weekend for you.
Dear Crayon,
You may like to e-mail the brain scan report to this website.
Thank you.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre / Beacon ISC
Hi Dr Lee, thank you for this blog. My name is Karen and my body easily get the static especially when using laptop and smart phone which I can feel the static goes into my body, and the worst part is I feel the pressure on my chest. I got the same problem 2 years back and it was ok after I wore the negative ion clothes, now it happened again but it doesn’t help even after I wore the negative ion clothes. Is this cause by nerve problem? If not what is the factor and any treatment to cure? Appreciate your advice. Many thanks.
Dear Karen
Heightened skin sensitivity is a common sensation which is not linked to any known medical condition. If in doubt, you may refer to your GP for a preliminary assessment.
Best wishes.
Webmaster
Dear Dr Lee,
My sister is sick. Symptoms are, constant hand shriving, unable to speak what she is thinking and having hullucintions. I want to know if Dr Lee is the right doctor to seek consultation.
Thanks
Ben
Dear Ben
Your sister’s symptoms may be due to conditions such as medical disease, extreme stress or psychiatric illness. The features do not suggest a neurosurgical condition. Do get your family doctor to make a diagnosis so that she can receive appropriate treatment.
Best wishes.
Webmaster.
Dear Dr Lee,
I’m so blessed to have found your website. Firstly, wishing you a Merry Christmas and Happy New Year.
My brother has numbness and stiffness in his left arm and weakness in his thumb and index fingers. Suspecting it to be a ministroke,he was recommended to go for acupuncture but it didn’t seem to help much. He can’t lift his arm and feels weak and has no use of his left arm now. This has been for almost 2 years already.
Just a few days ago, he decided to see a doctor and was advised to go for a MRI and it showed cervical spondylitis with mild cord compression at L3-4 – L4-5. The attending physician had prescribed the following medications: Dexasone, Arcoxia, Neurobion, Omesec and Aspirin.
His arm became totally stiff after taking the medication, with loss of movement in all fingers now. For fear of further stiffness, he discontinued taking the medications. He also had an angiogram done last week and found one artery heavily occluded. However he was advised to have the arm treated first and then angioplasty afterwards, due to medications which he will need to take after angioplasty.
We are all worried and desperate to know which is more important to be treated first and whether he requires surgery for this nerve problem. What do you think is his ailment. Your professional advice is much valued and we thank you for your time and kindness.
A million thanks and kind regards,
Linda Ng
Dear Miss Linda,
Thank you for your e-mail.
It is not easy to make a clinical judgement based on your description of his symptoms as a good history taking and thorough clinical examination is essential to elucidate the underlying cause of his problem.
You may want to consider taking him to see a neurosurgeon or neurologist.
Do bring along his MRI cervical spine films or CD. A nerve conduction study (NCS) may be necessary. Hopefully a correctable problem is identified and functional recovery is then attainable.
Thank you.
Regards.
Dr. Lee Foo Chiang
MBBS, FRACS ( Neurosurgery)
Consultant Neurosurgeon
Dear Dr. Lee,
I am Nur and i suffered trigeminal neuralgia and I’m 3 months pregnant. the pain is excruciating. i can’t sleep at night and it is also hard for me to open my mouth as the pain will attack me within minutes. thank you.
Dear Miss Nur,
Trigeminal Neuralgia responds well to medications like Carbamazepine, Lyrica or Neurontin, at least in the early stages. However your first trimester pregnancy complicates the issues, as we will have to take into consideration the potential teratogenic side effects of these drugs. They will be safer from 2nd and 3rd trimester onwards though not without risks to the fetus.
You may want to consult your gynaecologist on the safety of usage of these medications in your pregnancy.
Micro vascular decompression MVD leads to a long term cure in most cases. But again the same safety consideration with regards to anaesthetic and peri operative antibiotics and other drugs usage in pregnancy applies.
Thank you.
Regards.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre/ Beacon International Specialist Centre
Dear,
Dr Lee
My grandma now 68yrs now in hospital kuala lumpur. she has been coma using ventilator for 2weeks in HDU as she still can’t breathe on her own. She is diagnose as emergency hypertensive with CKD,AKI with dialysis and metabolic acidosis. my grandma creatinie and urea not control. after dialysis the urea down to 12-15 and creatinie down to 350-500 but after 24hours it raise up again to urea 20-25 creatinie 600-800. on the earlier stage she had pneumonia n now is recover. her BP and HGT also not really control and she need IV to stable the BP and HGT. recently her EEG report showing that she had “severe encephalopathy” and doctor telling us that she had a stroke that affect the back brain. So i would like to ask is there any chance that my grandma can transfer to Dr lee. my grandma this few day show a lot of reflect such as blinking eyes, open eyes, leg moving, mouth open. is this a good sign?
** doctor in hospital telling us that the condition is not that good and ask us to withdraw her.
Hope to get a reply from Dr Lee.
Thank you
Dear Ms Annie
From the information given, it looks like your grandmother is receiving the best available care for her multiple medical conditions. She does not appear to require neurosurgical treatment.
As such, it would be advisable to continue with her current medical team who seem to be trying their best to support her.
Best regards,
Webmaster
on behalf of Dr Lee
Dear Miss Annie,
It looks as though your Grandma has a neuromedical rather than a neuro surgical problem. You may want to consult a neurologist. Thank you.
Regards.
Dr. FC Lee
Consultant Neurosurgeon.
Dear Dr. Lee,
Thank you for this blog.
I have a question in regards with my father’s condition, 75 yrs old and had undergone HNP surgery around 4 years ago. However, about the last 6 months he’s been suffering from severe pain from the same spot from the surgery. The pain is very disruptive that it causes him lost of sleeps. Last month, he went to get another treatment from a pain clinic, in which the treatment requires him to be injected with needles on the place where he feels pain, and the needles were connected to cable with radio frequency. Again, this is also fails and still leaving him with lower back pain.
My father is also a heart patient and has undergone ring surgery twice about 5 years ago. The situation right now is very much difficult as he is in constant back pain and consuming pain killer often raise his gastric problem.
As an additional info, his movement is still ok, walking is not an issue except if climbing up stairs. He is now more hunchbacked than before the surgery and was not really good in wearing corset, or maybe it was not the correct model for his needs.
Hopefully we could get explanation on what is the right treatment for him.
Really appreciate your kind attention and response.
Thank you
Dear Ms Tina
Your father requires a clinical assessment and review of imaging scans before any recommendation can be proposed. Do speak with his treating doctors for further clarification. If in doubt, you could request for referral to get a 2nd opinion.
Best wishes,
Webmaster
Dear Doctor Lee ,
I’m glad to found this page and i hope to hear from you very soon . He’s from Penang and having cavernous malformation now . There is a well defined “popcorn” lesion seen in the right frontoparietal region . It is of mixed signal on both T1W and T2W1 . On T1W1 , it is of intermediate signal with a high signal rim . On T2W1 is it of high signal with a low intensity rim . It measures about 9.2mm x 8.6mm . Following IV contrast , a small gentle ‘blush’ is seen at the region of earlier observed abnormally . No abnormal draining veins are noted coming out from this lesion . This is likely to represent a cavernous venous malformation .
The interhemispheric fissure is centered in the midline . The cerebrum and cerebellum exhibit normal cortical sulcation . The ventricles are of normal size and symmetrical . The cortex and white matter show normal development and normal signal intensity .
The brain stem and cerebellum show no abnormal changes in signal characterictics , The sella and pituitary are normal and para sellar structures are unremarkable . The cerebebellopontine angle area appears normal and each side . The internal acoustic meatus has normal width . The visible paranasal sinuses and mastoid air cells are normal .
Impression:
Changes are in keeping with a cerebral cavernous venous malformation in the right frontoparietal region , measuring about 9.2mm x 8.6mm .
May i know the medical fees too ? Your professional advises and contributions are much appreciated please . Thank you Doctor Lee
C.wei
Dear C. Wei
Cavernous malformation, also known as Cavernoma or cavernous hemangioma typically presents with either epilepsy or bleed from its rupture. In most cases, it lends itself to a safe micro surgical excision under stereotactic guidance by a neurosurgeon. Complete surgical excision is mostly achievable and leads to a cure.
Please refer to your email for personal response.
Dear Doctor Lee ,
I’m glad to found this page and i hope to hear from you very soon . He’s from Penang and having cavernous malformation now . There is a well defined “popcorn” lesion seen in the right frontoparietal region . It is of mixed signal on both T1W and T2W1 . On T1W1 , it is of intermediate signal with a high signal rim . On T2W1 is it of high signal with a low intensity rim . It measures about 9.2mm x 8.6mm . Following IV contrast , a small gentle ‘blush’ is seen at the region of earlier observed abnormally . No abnormal draining veins are noted coming out from this lesion . This is likely to represent a cavernous venous malformation .
The interhemispheric fissure is centered in the midline . The cerebrum and cerebellum exhibit normal cortical sulcation . The ventricles are of normal size and symmetrical . The cortex and white matter show normal development and normal signal intensity .
The brain stem and cerebellum show no abnormal changes in signal characterictics , The sella and pituitary are normal and para sellar structures are unremarkable . The cerebebellopontine angle area appears normal and each side . The internal acoustic meatus has normal width . The visible paranasal sinuses and mastoid air cells are normal .
Impression:
Changes are in keeping with a cerebral cavernous venous malformation in the right frontoparietal region , measuring about 9.2mm x 8.6mm .
Your professional advises and contributions are much appreciated please .
May i know the medical fees too ? Thank you doctor
Best Regards
Dear Wei
Your enquiry has been responded to by private email. Below is Dr Lee’s reply:
Cavernous malformation, also known as Cavernoma or cavernous hemangioma typically present with either epilepsy or bleed from its rupture.
In most cases, It lends itself to a safe micro surgical excision under stereotactic guidance by a neurosurgeon. Complete surgical excision is mostly achievable and leads to a cure.
Hi Dr Lee,
appreciate your professional opinion on my mom condition after 3 yrs survive from stroke attack.
Health background;
16/09/2012
operation due to stroke attack. OP time 6 hrs. OP finding: Fragile of the neck of aneurysm, severe adhesion of the aneurysm. Operation: Right pterional craniectomy + Aneurysm clipping + Left EVD with ICP monitor.
26/09/2012
OP time 1.5 hrs. OP finding: High pressure of CSF drainage. Operation: V-P shunt.
My mom fully recover from the attack since then.
Recently in past 2 months my mom complaining about dizziness, it only happen when moment she lying down and wake up from bed. It’s just take about 5 second to disappear. Can Doctor briefly tell us what went wrong? Can we see you for the consultation or you prefer someone you know in northern region?
Dear Mr Ahmad
Please see your email for a personal response.
Dear Dr Lee,
My father having back pain problem recently (2-3mth already). He has gone through MRI scan and suspecting having the diskitis at vertebral T1/T2. His health condition still good to running daily activities as normal (eg: driving, eat, normal walking), only night time back pain attack make him difficult to fall sleep. Now he is taking some medicine antibiotic.
What is the treatment needed to overcome this illness?
Thank you.
Dear Mr Ting,
Discitis is usually due to infection by a common bacteria (Staphylococcus aureus). Treatment with appropriate antibiotics is the mainstay of management. Surgery is needed only if spinal stability is threatened or there is pus formation from spread of infection to spaces around the spinal cord or nerve roots.
Thank you.
Yours Truly.
Dr. LEE Foo Chiang
MBBS, FRACS ( Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre / Beacon Hospital
Dear Dr. Lee,
My wife is diagnosed with a cyst lesion on her left temporal lobe since 2013 & according to her MRI report, it is likely to be an arachnoid cyst. The size is 1.3 x 0.9 x 1.02cm. She suffers from temporal lobe epilepsy (automatism) due to this. The specialist we consulted in Ipoh advice against removing the cyst. Her treatment from Ipoh GH is just through seizure medication, which at times, doesnt completely stop the automatism. Is her condition common? Is it advisable to remove it? Im deeply worried about her condition and am hoping you can shed some lights into her condition. Your advice is truly appreciated. Thank you.
Dear Jason,
Thank you for your enquiry.
It looks like your wife has a small arachnoid cyst. We need to ascertain that her temporal lobe epilepsy (TLE) originates from the temporal lobe on EEG before considering taking out the cyst. Most arachnoid cysts are incidental and do not require removal. A good quality MRI Brain will however, allow us to exclude “scars” in the medial temporal lobe (medial temporal sclerosis) excision of which through stereotactic micro neurosurgery, will lead to excellent long term relief, even permanent cure of temporal lobe epilepsy.
Thank you.
Yours truly.
Dr. LEE Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre/ Beacon Hospital
i’m kanagah from perak this case regarding my brother get treatment in Singapore for Hydrocephalus Secondary to 4th ventricle intraventricular haemorrhage. now he become normal but we need to continue his followup checkup we the best place we can bring him.
Dear Kanagah
Your brother can see either of the Consultant Neurosurgeons on this website for follow up. Please refer to the addresses at this website.
Best wishes, Webmaster
Dear Dr Lee,
My mum is 75 years old, she complain of having thigh pain, area below the buttock. Sometimes the pain area move around. We went to see the traditional chinese specialist at Suntech Traditional Healthcare. puchong. They just prescribed us some herb medicine (more like nutritious powder). There isn’t any much improvement to the pain after a few visit & herb medicine taking. At times, the pain is quite severe especially when she walk or standing. The doctors there said her spinal cord has signs of bend inward, this causes the neurone to be under pressure (神经线被压着) (nerve compression?), The doctors didn’t recommend surgery due to her age. We have tried infrared light treatment (off the shelf product) to relieve the pain areas, but the symptom persists.
Hence, we would like to seek second opinion on the treatment to cure or relieve the pain. Appreciate your advices.
Thanks
kc
Dear KC,
You can bring your mother to see a neurosurgeon and have an MRI lumbar spine done. If the MRI confirms a disc prolapse, She may benefit from a micro lumbar discectomy.
Thanks.
Dr. Lee Foo Chiang
Consultant Neurosurgeon.
Sunway Medical Centre / Beacon Hospital
Hi,Doctor Lee,
Appreciate much for your professional opinions. We are facing a big problem here. My nephew suppose go for surgery today in Sungai Buloh(cutoff the brain tumors). But they cancelled it last mins,reason is the operation room not ‘chilled ‘enough,is it make sense?and the doctors advise either to wait one more week or transfer him to GH Kuala Lumpur.is it meaning they have no confidence for the operation? Can i attach my nephew’s CT scan And MRI scan to u, and we eagerly hope to hear from your professional opinions.we r terribly anxious now,please help my poor boy. Thank you, doctor
Regards,
Nancy
This case has been resolved; appropriate treatment was administered.
Webmaster.
Hello doctor,
I hit my right side of head about one year plus. Ever since then I am having pricking sensation/pins and needles all over my body and I often get static. I have done mri everything seems normal. Can you advise what can I do to get rid of the pricking pain. It happens all the time and last for all day long.
Dear Sri
It is good that the MRI scan does not show any brain damage. Quite often, bodily sensations arise with no evidence of injury. In such a case, you could obtain medications for symptom relief from your family doctor, in the expectation that these symptoms are likely to subside.
Best wishes, Webmaster
Hi Dr Lee, my nephew is 5 years old, did the MRI and just diagnosed a tumor in brain and cause ‘water’ retain in brain, today had undergone a minor surgery to evacuate the water.
There is another major surgery (to remove brain tumor) and we need to make decision latest by this Friday. We are worry as the surgery take high risk esp. to a 5-year-old boy. I sincerely seek for your professional advice whether to carry on the surgery or consult other specialists. Would you have recommendation of brain surgeon or pediatrician? Much appreciate to reply asap with your valuable advices.Tqvm
Dear Miss Nancy,
Post fossa tumour in children causing obstructive hydrocephalus requires a VP shunt followed at a later stage by microsurgical removal of the tumour. The operations done by experienced neurosurgeons are generally safe and straightforward. Surgery takes typically 3-4 hrs with a low mortality risk of 1-2%. Patient stays in ICU for 2-3 days post surgery and in normal ward for another 2-3 days.
A good tumour clearance can be achieved under operating microscope using ultrasonic surgical aspirator and aided by stereotactic image guidance. It is considered “bread and butter” surgery amongst the numerous brain tumour operations in my practice every year.
Thank you.
Dr. LEE Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre / Beacon International Specialist Centre
603-74910777, 603-74919191 ext 15519.
Hi Dr,
I am 52 years old. I was recently diagnosed with craniopharyngioma, and the tumor has already compressed on my optic chiasm, causing me to have partial blindness of both my eyes. I would like to know what is the recurrence rate of partial resection of the tumor since total resection is impossible? And which hospital or neurosurgeon would you recommend from Ipoh?
Thank you.
Dear Eileen,
Both the private hospitals and government hospital in Ipoh have neurosurgical service. You may also want to consult some of the senior neurosurgeons in KL.
Thank you.
Yours Truly.
Dr Lee Foo Chiang
Consultant Neurosurgeon
Dear Dr lee
I am a 46 year old male I am suffering from tinnitus is there any surgery possible to stop or at least reduce the high pitched noise in my ears? Thank-you
Dear Manoj
Tinnitus is treated by Ear, Nose and Throat specialist. Medications are helpful for acute attacks. Surgery is rarely recommended. Do consult your ENT doctor for proper advice.
Best wishes, Webmaster
Hi Dr. Lee,
Is MVD an elective surgery? If I am diagnosed with hemifacial spasm, will the cost of the surgery be covered by my medical insurance?
Thanks for your time.
-Natasha
Dear Natasha
Please refer to your email for a personal response.
Webmaster
What is the charges like to perform MDV for Trigeminal Neuralgia.
Female patients about 59 yrs
Tks./
Mr Ng.
sengtek168@yahoo.com
Dear Mr Ng
Thank you for your enquiry. Every patient needs a personalised assessment to plan for treatment. This includes review of other medical conditions and any special requirements. As such, you are kindly advised to consult Dr Lee for detailed discussions at the contacts listed in this website.
Best wishes,
Webmaster
hi…Dr Lee,if i do MRI last year ..when should i do check up-MRI for this year?if i prepare to pregnant ,is that any badness for me?tq…
Dear Miss Low
You need to discuss with doctor in detail about this issue. Please do contact Dr Lee at his clinic.
Best regards,
Webmaster
李医生好
你明天（14/9/2015）on duty在哪间医院？我知道你本身是在sunway mediacal.. 可是你的appointment time没有注明14/9的时间
麻烦医生你尽快回复，我们想尽快让外婆给你检查。
Hi your enquiry has been responded to via private email.
Hi dr, i’m 43 years old. I’m working as an artist. 5 months ago i had a pain at neck.already took x-ray and my c4.c5.c6 looks a bit straight…in same time i quit smoking for five months,, i feel headache, dizzy, shoulder pain and feel very tired…..Need your advice,TQ
Dear Sir
Since you have multiple symptoms, a clinical assessment is needed to identify any problem(s). Do see your GP for an initial appraisal.
Best wishes.
Webmaster
Dear Dr. Lee,
I would like to seek your professional advice on my father’s condition. He suffered a stroke 3 months ago and his right side was affected. He has undergone acupuncture treatment and physiotherapy for more than 2 months. However, his arm and leg is quite stiff and painful whenever I try to some stretching exercise. I heard from my GP that Botox injection can help. Does Dr Lee have this treatment? How much does it cost? Appreciate if you could advise.
Dear Sir
Botox is indeed one of the treatment options for post-stroke spasticity. It is performed by Neurologist. Please see your personal email for details.
Webmaster
on behalf of Dr Lee Moon Keen
Dear Doctor, an 80 year old female is experiencing numbness, slight swelling and some itchiness on both feet. Symptoms started since last year (2014). At first, only on 1 foot, now both feet. Blood test done 2 weeks ago, no evidence of diabetes. Patient can walk but slow due to numbness. No problem standing. Numbness is continuous, day and night. What is the cause / are the causes and what treatment do you recommend? Thank you. Regards, Pat Hiew
Dear Pat,
The symptoms described require clinical assessment and probably further tests to arrive at diagnosis and treatment. There are many possible causes including varicose veins, heart failure, and neuropathy, just to mention a few Do discuss with the family doctor about the need for other tests and/or specialist referral.
Best wishes,
Webmaster
Dr Lee,
I read you earlier message with regards the deep brain stimulation surgery , may I know what is the estimated charges?
Thank you.
BR,
Chin
Dear Chin
The estimated charges are around USD 40,000.
Best regards,
Webmaster
Dear Dr Lee,
I have HFS on the right side of my face. Botox injections only give slight relief. Eye and mouth are affected and it does impact my working life. Would surgery be an option? What is the risk? Is it frequently done in Kuala Lumpur? How long would i be hospitalized? Any after care/restrictions? Thanks in advance for your response. With best regards, Adrian
Dear Mr. Adriaan,
Micro vascular decompression micro neurosurgery for hemifacial spasm has been performed regularly in my practice since 1988. It is a very safe procedure. The main potential morbidity is loss of hearing on the operated ear which used to occur in the range up to one in four cases. This is reduced nowadays with the use of intraoperative hearing monitoring ( BAEP).
Surgery takes about one and a half hrs. Hospitalisation of 3-4 days after surgery is needed. Total estimated cost of treatment is in the range of RM 55-60k ( USD 15-16k)
I hope you find these informations useful.
Thank you.
Yours truly.
Dr. LEE Foo Chiang
MBBS, FRACS ( neurosurgery )
Consultant Neurosurgery
Sunway Medical Center/ Beacon International Specialist Center.
603-74910777
Dr Lee good day to you, I m so glad that I found this channel to communicate with doctor for your professional advise as I m totally lost in direction.
My sis 25 years old. Since young she appears to be slow mover as she talks slow n steady. We didnt put much concern as we thought it was her style due to bad hearing. she did one time operations on norse when young due to bad hearing. She started to have headache 2, 3 yrs back and she complaint neck pain. We thought massage caused her nerve injured. As she often said headache, she started to wear hearing aid mid 2014. Due to her neck condition that getting worst (fainted, lost concentration, often look blankly, neck pain till body bent S shape as to release pain, often want sleep) we bring her ent n Xray, doctor said bit crook bone but not big deal as could be due to her work that often need ban down her head. No ct scan or mri doctor said no need as no accident record.
Last week, she shit on bed while mum called her up morning n she couldn’t speak or respond that time, couldn’t walk. After some times she ok n vomit n rest then she back to normal next day. She couldn’t remember the incident. Doctor I m worry she has central nervous system disorder pls guide me on how to go for it as I do not want to bring here there and see the wrong one wasted money n time n miss the golden time to cure her.. thanks doctor for your kind advise!
Dear Lin
Your sister has a complex list of symptoms. Her doctor is in the best position to assess what may be the problem(s). Do speak with the doctor for advice on which specialist should be consulted.
Best wishes.
Websmaster.
Thanks, doctor. Her last visited doctor recommended her to see neurology. But we have yet to bring her as she sometimes appears ok and her neck pain reduced
李醫生你好，
我今年二十九歲，今年二月發現突然看東西時有雙影，通常是發候睡醒的時候，過了一會沒事，可是完全沒有頭痛或任何其他症狀，最近這兩個月會開始偏頭痛，眼睛痛，鼻梁痛，噁心，想吐，通常也只發生在剛睡醒時，上個月去看了醫生，照了 ct scan 然後 mri 發現有一顆良性腦瘤在右腦然後壓到眼睛的神經線所以會導致眼睛出現狀況，醫生建議我說可以選擇開刀拿掉沒有壓倒神經線的瘤，處於拿不掉的需要電療，或者第二選則不開刀只電療。我希望可以聽聽李醫生給我的建議。謝謝。
我建议你可以带你的脑MRI 照片或是CD 到我所服务的专科医院作个详细的臨床撿查及讨论治疗方法。
谢谢。
李富强腦外科医生
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Sunway Medical Centre/ Beacon Hospital
603-74910777
603-7620 7979
Dear Dr Lee,
My daughter has been diagnosed with Cerebella Tonsillar Octopia with 5MM after MRI SCAN.
No evident of syringomyelia noted at cervical spine
No hydrocephalus
Is her condition can be treated? Is the surgery dangerous? How much will be the costs?
Dear KL
Your enquiry has been responded to via private email. Below is Dr Lee’s reply:
Dear Mr Kee Lam,
Cerebellar tonsillar ectopia cab be treated with Gardner’s operation i.e. Craniovertebral decompression which is a straightforward and safe micro neurosurgery procedure.
Operation takes about one and half hrs and requires hospital stay of 3-4 days.
Hi,
I have a very bad headache for 9 days now. The pain when it started, was like an explosion. N it’s accompanied by neck pain n stiffness. The pain radiates from the left back part of my head to my neck. I’ve seen a GP n the Dr says it’s migraine n prescribed a muscle relaxant n migraine pills. It’s not working n I’ve just finished the medication. The pain is horrible. Please could you advise, do I come in for a ct scan ?
Thank you.
Dear Patricia
Your doctor is in the best position to assess the pain and to consider its cause, be it migraine or some other condition. Do see your doctor for reassessment and to discuss the necessity for brain scanning.
Best wishes, Webmaster
Thank you, I’ve been to the ER and a neurologist, had a MRI scan done. Was on medication n much better now.
李医生您好，
我家婆今年48岁，8岁昏倒撞头，28岁发现脑积水，未曾开刀。上个月开始不舒服，出现类似感冒症状，发烧颈项肩膀头疼，手脚麻眼睛蒙。看了几家诊所都查不出原因，就决定再照MRI .
MRI 结果显示脑积水的部分是黑色蝴蝶型的，可是中间有一处是灰色。
第一位 说必须马上开刀，permanent tubing引流到胃，否则会失明等等
第二位医生对灰色地带比较忧心，要我们做CSF flow study 和 flare。
所以我们想要再咨询医生的意见。。
请问，CSF flow 和 flare 在新山有得做吗？如果在你们家， 一般收费在多少？
手术的风险和康复率以及复发率呢？
有没有什么并发症呢？谢谢
Dear Miss Esther,
Thanks for your enquiry.
MRI CSF flow study is a common test and can certainly be done at Sunway Medical Centre or Beacon International Specialist Centre. Cystoperitoneal or ventriculoperitoneal shunt are simple neurosurgical procedures with overall risks of <1%.
Regards.
Dr. Lee Foo Chiang
Consultant Neurosurgeon.
Sunway Medical Centre / Beacon International Specialist Centre
李医生,
您好!我的儿子今年十二岁,四个月前开始出现非常疲倦的状况,非常爱睡,很难叫醒他。晚上九点半前睡着,早上五点半起不来,刷牙穿衣都要我不停的叫,才能做好,在学校上课考试都一样会睡着,很难叫醒他,放学回家午睡两小时也不能起床
,如果是周末,可以睡到中午十二点也不起床。起初以为他功课太繁重,睡眠不足所至的。三个月前给他补充很多营养品,可是都没有见效,就去看了脑科专科医生,起初医生开了arcalion, melatonin给他服用,情况沒有改善,然后做了MRI, sleep study,沒有发现有什么不妥,医生怀疑是嗜睡症(narcolepsy) 现在开了 ritalin10mg早午各半粒,服用 二天后沒效,增加早午各一粒,他的身体出现不适,心跳至120还有点痛,医生又建意减去早中午各半粒,心跳115还是有点痛,鼻塞,咳嗽及脚下半部有红疹)在这种情况下还要继续给他服用吗?还有另外一种药是concerta18mg(服用ritalin五天后才开始)每天一粒,服一星期。李医生,我儿子到底是怎么了?服用这些药对他以后影响大吗!因为是兴奋剂。
您有什么好的建议,我好担心,谢谢!
Mrs. Lai 女士，李醫生是神經外科醫生。合適的人來諮詢一下你兒子的療程為“NARCOLEPSY”，是他的醫生。
最良好的祝愿，站長
Dear Dr. Lee,
I have a brain aneurysm. I would like to seek for second opinion. Can I make an appointment with you?
Dear JP
Please contact Dr Lee’s clinic at the numbers in this website.
Best wishes.
Webmaster
Hi Dr Lee,
My mum suffering from insomnia in the past few years and sometimes she can fall a sleep at night but she is a very light sleeper. Recently her condition is getting worst and she told us that her brain being too active and unable to relax/switch off at night even during holiday, hence her insomnia problem is getting worst. We are unsure whether you provide any treatments for this type of patient (except sleeping pills)? Please kindly advise. Many thanks.
Dear Stephy
Your mother needs a psychological evaluation for the symptoms. You are right, sleeping pills are not the ultimate solution.
Do talk to your GP to arrange for a psychiatric referral to be made.
Best wishes.
Webmaster
on behalf of Dr Lee
Dear Dr Lee,
My friend suffering from paraplegia . I wonder if there is treatment for him.
Regards,
Dear Warid
Choice of treatment for paraplegia is determined by the cause, be it trauma, infection, degeneration of spine, etc.
Do talk to your friend’s doctor for guidance.
Best wishes.
Webmaster
on behalf of Dr Lee
Hi dr lee,
My mom has been diagnosed with mild stroke last week by a GP. Currently she is taking aspirin and medicine to lower her blood pressure. No further action has been advised. She is still quite week, can’t walk too much and has little numbness on her right face. Cant u advise us what is the next step that we should take ?
Thanks a lot..
Dear Nicole
Every patient needs to be assessed individually before any treatment can be recommended. If you are concerned about your mother’s progress, do consult her GP again. If necessary, she can be referred to a specialist.
Best wishes.
Webmaster
on behalf of Dr Lee
i AM FROM BANGLADESH . I HAVE A PATIENT WHO HAS WATER IN THE BRAIN. CAN WE DO OPERATION?. PLEASE GIVE ME YOUR EMAIL ADDRESS
Dear Mr Teraj Uddin
Thank you for your enquiry.
Hydrocephalus (water in the brain) can be easily treated with either Ventriculoperitoneal shunting which is a minor neurosurgical operation, or neuro-endoscopic fenestration.
Thank you.
Yours truly.
Dr Lee Foo Chiang
Consultant Neurosurgeon
Beacon International Specialist Center / Sunway Medical Center
fclee.neurosurg@gmail.com
+603 74910777.
Dear Dr Lee,
I have read your website and knew that you have enormous experience on the neurology treatment. I believed with your substantial experience, you will be able to assist me as I really need your precious advices for my mum’s case. She is 72, she has diabetes, high blood pressure, heart beat weak. She has been suffering from bilateral by burning for years, have been treated many doctors, however, the burning was unable to cure. Recently, the situation become worst and she suffering badly.
I am sincerely seeking Dr Lee’s precious advices to how to treat this type of bad burning.
Hope Dr Lee will be able to respond my request. Really appreciate that.
Dear M Loon
Your mother has a complex situation. She needs a thorough evaluation of clinical status and test results before any treatment can be offered.
You may wish to consult Dr Lee Foo Chiang at the address on this website.
Best wishes,
Webmaster
Dr lee, my sister has migraine, she has headache every day. Can she do the ct scan on brain?
Dear Carrina
Your sister is advised to consult her family doctor if she would like an assessment to determine which investigations are appropriate. These may turn out be blood tests, imaging scans or other neuro studies. Besides migraine, there are a number of causes for daily headache, including anaemia, thyroid disease and other systemic disorders.
Best wishes,
Webmaster
Dear dr. Lee,
My wife got Hemifacial problem. Do you do surgery for this case?
Dear Mr Budiman,
I have been performing Microvascular decompression MVD surgeries regularly for hemifacial spasm and trigeminal neuralgia since 1985. It is a very safe and rewarding surgery with high chance of permanent cure.
Please feel free to contact my office for consultation and further discussions.
Regards.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Malaysia
+603-74810777
Dr Lee,
Do you help people to get rid of sleeping pill , like Alprazolam.
Tq.
Celine
Dear Celine
The specialist for this problem is a psychiatrist with interest in Addiction Medicine.
Best wishes,
Webmaster
Dear Dr. Lee
My brother he is 29 years opd had bleeding in cerebellum for unknown reason in September 2014 he was in hospital for over a 6 month. He suffer many side effect of multiple ataxia semptmos. Heavy speech . Cant walk . His left eye and left part of his face can not control He lives in germany . Dusseldorf he is now getting treatment of diffrent therapy types . Does acupuncture treatment will help his condition . Is there anything else we can do ?
Dear Rodi
Please accept our apologies for late reply – your post was caught in the spam filter. Your brother is likely to be receiving “state of the art” rehabilitation in Dusseldorf. Acupuncture has not been shown to be evidence-based treatment for neuro rehab. Please do encourage him to persist with treatment in Germany.
Best wishes, Webmaster
Dear Dr Lee,
I had a mild case of cerebal Palsy since birth. I was on physio therapy for several years.
The doctors at that time said there is no cure. I have a normal growing up years with allergies to some medication.
I am now 33 years old. Recently i find my self not able to balance well and its I find it hard to talk sometimes
Is it related to the CP i had ?
Dear M Tan
You seem to have done well with physiotherapy. If you would like to find a cause for the change in functioning, a re-evaluation is needed, preferably by the team which treated you previously. Otherwise, you can consider a neurological reassessment.
Best wishes,
Webmaster
Dear Dr Lee
My husband is a quadriplegic who had a hip dislocation and in constant pain and want to do rizotomy. Do you do this procedure?
Dear Ms Joseet
Your husband as a complicated situation. Management should be tailored to his condition. Do consider meeting Dr Lee to discuss, at the address on this site.
Best wishes.
Webmaster.
Dr Lee, may I know the technic that you use for brain tomur operation?
Dear M Lee
Surgery techniques for brain tumour are guided by the nature of the tumour, its size and location, as well as the patient’s general health, i.e. no one size fits all.
Webmaster
on behalf of Dr Lee.
Dear dr lee,
I’m 16 and I had sex. I haven’t gotten my period since then and it’s been 3 months plus. I went to test for the pregnancy test 2 times and it was negative. I have no stomache, nausea, nor any pregnancy symptoms. but the only thing I had was really little bit of brown discharge like during the first month and second. what do I do.. please reply. I’ve been stressing out worrying about this for quite some time.
Dear Jxxx
This website is not able to provide the advice you need. Do see your family doctor for checkup and help.
Best wishes.
Dear Dr. Lee,I have Cervical Hernia on my right side of my neck since several years back, recently it has been worsen. After X-ray doctor told me its at C4, C5,C6. My upper shoulder straight down to my 3 last fingers will produce numbness and electrical shocks of and on, more obvious when sitting down. At present l am under chiropractic therapy. But not much improvement, please advice is it possible to have surgery, l hopefully to ease it once for all.
Regards
Sam Wong
Age: 64
Profession: Textile Chemicals
Request: Can l have a personal mail reply. Thank you.
Dear Mr Sam Wong,
Cervical herniated disc with nerve compression can be safely treated with anterior cervical discectomy and interbody cage fusion or artificial disc replacement. This is a microsurgery commonly doneb y experienced neurosurgeons.
Relief of pain in most cases is immediate. It requires 2-3 days of hospitalization and patients are ambulating by the time of discharage.
Thank you.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre
Recently my sister has giddiness and double vision for more than a week. She did CT scan at a hospital and the report described blood clot. Her doctor referred her to a neurosurgeon at another hospital. She was sent for MRI and the report described pontine cavernoma measured 2cm x 1.6cm. She was advised to have surgery to remove it. However, we would like to seek second opinion; especially the risks involved.
Dear M Hoh
Please contact the neurosurgeons on this website for thorough clinical evaluation and advice.
Best wishes.
Dear M Ng
Please contact the neurosurgeons on this website for thorough clinical evaluation and advice.
Best wishes.
Dear Dr Lee,
I was diagnosed of having right meniere ‘s disease. im having symptoms like giddiness and nausea. on the 20/4/15 i went for a CT scan and they found out that there is right fossa cyst. my appointment with government hospital is still a long time to come. can u kindly advice me on the possible treatment? do i have to undergo any surgery to remove the cyst? what are the best treatment available now for my condition?
thank you
Dear Dr Lee,
I had a mild case of cerebal Palsy since birth. I was on physio therapy for several years.
The doctors at that time said there is no cure and because its mild i should use my mind to control my coordination. I am now 33 years old. I find myself not able to control my balance and movement (constantly shaking) with my mind and I think my speech is slowing down. I know what I want to speak but I can’t get the words out clearly.
My mother says nothing is wrong its just my habit of not controlling myself. I think something is not right. Should I be seeking professional help and where to get such help?
Dear Dr Lee,
I am 28, female, suffering from epilepsy since I was 12. It started one day when I was asleep. According to my parents, I suddenly let out a loud scream and had seizures. I usually bite my tongue and the left side of my body shakes. After that, I became unconscious. After some time, I became conscious and felt very weak and tired, with extreme pain at the back part of my head and eyes. For several years I continued having seizures within several minutes after I fell asleep. This happened once or twice a month until I was 18. Then, I didn’t have any seizures when I was 19 till 21. Suddenly, one day I collapsed when I was awake, became unconscious and had seizures. This was my first attack when I was awake. Till now, I am getting seizures when I am awake, and after several minutes of it ending, I get another one too, sometimes two or three at a time. I have taken MRI and EEG tests and doctor (neurologist) said that there wasn’t any abnormalities in my brain activities. They recommended me to take Lamictal to control my epileptic frequencies. Is there any treatment to cure this problem? How has it changed from occurring during sleep to now at awake? It is definitely affecting my daily activities and situations at my work place. It also affected my vision, as my left eye’s power has increased a lot. Please advise.
Dear Madam
Seizures can occur at any time of the day or night. The EEG provides definite proof of seizure attacks. However, since the recording is done done over a limited time period, seizure activities may be missed. To overcome this, 24-hour video EEG can be considered. Alternatively, people with epilepsy may have non-epileptic seizures (NES) too. Treatment for NES obviously will not be not antiepileptic medication. Do discuss these issues with your doctor. Finally, for information, epilepsy does not affect the eyes.
Best wishes, Webmaster
Dr Lee
您好!想向您寻问有关我爸爸在去年十二月，因发生了事故，照了plain ct scan,証实得了right external capsule old infarct with underlying age related celebral atrophy.最近,发觉眼睛不时在眨，每当睡醒，左眼都感不舒服，疼痛，双手颤抖，有时大便没知觉，猜测他有痴呆症状，想让爸爸到医生那做一些脑部检查。1)若要知道有无癫癞症状 可做那些检查？2)像爸情况 要做那些检查，个别检查费用约多少？3)要如何医治？
医生您可回复在我email上，谢谢您
Dear Miss Tan,
可以带您父亲去做脑部扫描MRI Brain。至於癫痫症的檢查则是需要脑电波EEG. 国内各大医院都有这类的设备。
谢谢。
祝愿安康。
李富强医生
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Dear Dr Lee, I’ve diagnosed hemi facial spasm at my right face since 7 years ago & currently doing botox treatment at GH . But recently I noticed that my left eye started twitching . I worry that it will getting worse . Can I go for botox injection for my left eye too. Beside botox what treatment I can do.
Dear Sarah
Hemifacial spasm (HFS) remains on one side. If you have symptoms on the opposite side, do consult your doctor about other possible explanations. It is not likely to be due to HSF affecting the opposite side.
Dear Doctor
I am female aged 48 years old. I*ve been told by my doctor that I*ve got Multiple Sclerosis (MS) It was diagnosed based on the MRI and the results of the lumber puncture done. The results are as follows:
Oligoclonal bands DETECTED in this sample.
The finding suggests intrathecal immunoglubulin synthesis.
Based on the above the doctors confirmed that i have got MS.
Before this, I had tingling feeling on my feet and hands. This feeling became worst effecting my whole body. When I walk or stand I get tired fast. My right leg becomes really numb until I have to force myself to walk. Feels like my blood is not running to my head. My face and under my sole are pale.
I was given 5 dose of the steroids drips. I forgot the name. After the drips, I felt better. But I was told that, that was not the treatment. and my problem will come back.
1. So, what shall I do? The doctor told me that the treatment is expensive.
2. When should I start this treatment?
I am now on Neurontin, Revicon Forte and Neorobion.
The doctor also told me to go on Fampyra 10mg. I am taking 1/2 tablet at night.
I am a little worried about the my future. Whats going to come next. It seems that all this medication is on trial. I feel like a TEST. I would like a second opinion. What do you advice?
Awaiting your kind reply in anticipation.
Thank you.
Prema.
Dear Prema
From your account, you had a thorough clinical evaluation followed by the necessary investigations, to arrive at the diagnosis of Multiple Sclerosis.
MS is a complex condition with a wide range of severity. Your treatment has to be individualised according to your condition. The recommendations proposed to you appear to be appropriate for MS. The practice guidelines for MS contain only treatments which have been proven in clinical trials of MS patients to be effective. No experimental therapy can be offered to you except with your express consent.
Do discuss your concerns with your doctor if you have doubts. You can of course request to be referred for a 2nd opinion.
Best wishes, Webmaster
Dear Dr Li,
i have a recurrent of chronic lower back pain since 2008(reprolapsed), disectomy of l4/l5 disc done in 99. it was associated with sciatica. do you do Radiofrequency or can recommend any dr that do radio frequency? last Rf I did at Uiam; but their RF machine is out of order. id tried conservative treatment for 6 weeks; but not much improvement.
Dear Ummu
So sorry to hear of your recurrent problem. RF is not yet offered at our centre, so you will need to look for alternative providers.
Best wishes for your recovery.
Webmaster
Hello Dr.Foo, Recently I faint in office with my eyes open. its that any problem with my brain?
Date: Tue, 21 Apr 2015 23:57:26 +0000 To: poorneema2009@hotmail.com
Dear Madam
Fainting may be due to many causes, including dehydration, fasting, loss of blood, heart disturbance and of course, neurological conditions. You are advised to first consult your family doctor for initial assessment.
Best wishes, Webmaster
Dear Dr.LEE. my husband has been detected “Pituitary Macroadenoma” (4 cm) by doctors in Penang through MRI. So I want to know more about this and I am planning to bring him to KL for more consultations. Do Dr.LEE handle a case like this? please reply and tq for your time. Regards : Nurliana – Indonesia
Dear Ms Nurliana,
Pituitary macroadenoma can be safely removed microsurgically / endoscopically by neurosurgeons. This is done through the nostril. It is a common operation in my practice.
The overall risk is less than 1%. Surgery takes 1 1/2 hr and 3-4 days of hospitalization.
I hope you find these informations helpful.
Thank you.
Dr. Lee Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre.
Dear Dr Lee
I am suffering fr back pain for almost 4yr n recently I hv pain in my buttoks,I do a research in web n I found similar as called sciatica.wat I am suffering now pls help…..
Dear Ganish
Yes your description could fit in with sciatica. However, there are other causes which need to be considered. Do consult your GP for further evaluation, in order to exclude other less common but more serious causes of back pain.
Best wishes.
Webmaster
Dear Dr my mum has problem with her right leg eversince she fell 2 years back.she cannot walk well n suffers in great pain.someone told me about’nerve block’jab.plz advice tq for your time
Dear Swaseni
Your Mum’s condition needs proper clinical assessment in order to formulate any treatment recommendation, including nerve block. You may wish to either consult her doctor or make an appointment with Dr Lee.
Best wishes, Webmaster
Dear Dr. LEE Foo Chiang
Firstly, thank u for having this platform! Appreciate your advice and comments on my husband’s condition.
Few months ago, my husband (age 74) started feeling numbness and lost control/strength on his fingers. We thought it could be because of his Atrial Fibrillation (currently under control by medication) or that he had a mini stroke.
He then went for an MRI scan of his cervical spine and found the following :-
– Gross cervical spondylosis. Multilevel gross disc herniation with cored compression, foranimal narrowing and nerve root impingement. It is worst at C4/5 with underlying myelopathic change.
– The cord appears relatively flat at the cranio-cervical junction. It is of unknown nature and significance. there is however no focal myelopathic change at this level.
He is currently 74, has Atrial Fibrillation, respiratory sensitivity (occasional wheezing), and insomnia. He now has difficulty controlling his limbs (i.e. can’t button shirt, can’t hold pen, weakness in legs, he has difficulty walking), and just today started to have difficulty reading (can’t see clearly).
The doctor suggested wearing a neck guard and take Neurobion.
What are your advice on his options, risks of treatments and chances of recovery? Greatly appreciate your kind insights.
Regards,
Mrs Ng,
Klang
Dear Dr. LEE Foo Chiang
Firstly, thank u for having this platform! Appreciate your advice and comments on my husband’s condition.
Few months ago, my husband (age 74) started feeling numbness and lost control/strength on his fingers. We thought it could be because of his Atrial Fibrillation (currently under control by medication) or that he had a mini stroke.
He then went for an MRI scan of his cervical spine and found the following :-
– Gross cervical spondylosis. Multilevel gross disc herniation with cored compression, foranimal narrowing and nerve root impingement. It is worst at C4/5 with underlying myelopathic change.
– The cord appears relatively flat at the cranio-cervical junction. It is of unknown nature and significance. there is however no focal myelopathic change at this level.
He is currently 74, has Atrial Fibrillation, respiratory sensitivity (occasional wheezing), and insomnia. He now has difficulty controlling his limbs (i.e. can’t button shirt, can’t hold pen, weakness in legs, he has difficulty walking), and just today started to have difficulty reading (can’t see clearly).
The doctor suggested wearing a neck guard and take Neurobion.
What are your advice on his options, risks of treatments and chances of recovery? Greatly appreciate your kind insights.
Regards,
Mrs Ng,
Klang
Dear Mrs Ng
His cervical cord compression with resultant weakness and numbness of limbs can only be corrected with microsurgical decompression from either the front (anterior cervical discectomy) or back (cervical laminoplasty) which can only be ascertained after clinical assessment and review of his MRI. Due care to the atrial fibrillation is needed as we may need to withhold his anti-clotting medication perioperatively.
Functional improvement can be anticipated.
Thank you.
Hi Doctor Lee,
Good day to you. Would like to obtain professional opinion from you. My dad has suffer from minor stroke on Monday, he was immediately send to do acupuncture to release blood and air (I am not family with this and not sure the process help). Now, his right side of his body has no strength and will not able to walk, he still can move his right hand & leg while laying down. I want to do a thorough scanning and checking for him to see if any blockage. What is the kind of scanning or what kind of checking I shall bring my father to?
Thanks so much and appreciate this.
Regards
Jo-Ann
Dear Joann
Your father needs a clinical assessment by a doctor to determine what kind of tests are needed, in order to prescribe the appropriate treatment. Do consult your GP for advice on the next steps.
Best wishes,
Webmaster
Dear Dr. Lee’
My husband is 60 yrs old and have been sick for the last 19 yrs. Recently a neurologist in Penang diagnosed my husband with anxiety neurosis. In the beginning the medication prescribed by the specialists works. The pain was minimised but after 2 mths the pain was back to what it was before. This situation has been the same for the past 19 yrs. Can you advice me who I should consult as I seen most of the neurologists in KL namely Dr. Abu Salim of Tawakkal, Dr. Sng of gleaneagles, also those from prince court, Ampang putri, KLJ group, pantai ipoh etc.
Appreciate your help on this matter
Dear Rogayah
Dr Lee Foo Chiang is able to offer neurosurgical expertise for surgical conditions. In the case of anxiety neurosis and chronic pain, surgery is not appropriate.
Best wishes,
Webmaster
Thank you. Much appreciated.
Dear Dr Lee,
I have been suffering from migraine since my teens. Of late, I noticed I get it before and after my menstruation. However, this month is different. I’m having migraine as I write to you now since the first day of my period, which was on the 12th Feb. It’s been 12 days already and this isn’t normal, is it?
I’m not sure if this warrants a MRI? Please advise. Thank you.
YSL
Dear M Lee
It is not possible to provide advice based on the linited information given. You may wish to first consult your GP, as to what should be the next step.
Best wishes.
Webmaster
Dear Dr. Lee.
My name is Hanan, 34 years old and a mother of 2 years old baby girl. I do live and work in MY for last 7 years. Following my pregnancy I started with cramps in my legs by which I was told is normal to experience during pregnancy. However the cramps turned into sever condition in more frequent attacks day and nights after I gave birth. My muscles cramps and becomes too hard that at times I feel is going to break my bone. I am diagnosed with mixed connective tissues more than 12 years ago but I have no SLE, just have developed morphea. My ANA still is high (640) but all the other tests that I have been through on and off during last 3 years all came negative. I did some tests on my nerves and ranged normal (no MS), I have done two MRIs and other than a very slight slip disc seems okay. I also completed blood test and all the minerals are in normal range. Doctors told me they are in dilemma. I have sever attacks for nights. I can’t sleep, I can’t rest. Nothing works. Please advise what should be my nest step as I can’t live further without getting this pain diagnosed. Thank you very much.
H.H
Just an add on information on my cramps. The stiffness may force my leg joints to move and turn without me having any control over it. The pain is so sever that at times I will shout for help (if at home)!
Thanks
H.H
Dear Hanan
Since your condition appears to be complex, you need to have a thorough evaluation of your clinical condition and test results before any treatment can be recommended. Your condition could require either rheumatological or neurological opinion. Would you like to request for doctors for an appropriate referral.
Best wishes.
Webmaster
Dear doctor i would like to ask what an atypical hemangioma may be? I have one in my cervical spine does this need treatment it further investigation
Dear Sarah
It is not possible to comment based on the limited information. A spine specialist would be able to advise on this.
Best wishes.
Webmaster
I’m from bangladesh. my son is 13 years old. unfortunately he had been affected by moyamoya. doctors of bangladesh told me that the patient need a by pass surgery. sir, if u will do the surgery at sunway medical centre, Malaysia. how much us dollars will be needed? pls ret
urn me an email as early as possibe .regards mr. rana
Dear Mr.Rana,
EC/IC bypass surgery (direct and/or indirect) as cerebral revascularization for various conditions including Moya-moya disease have been performed in Sunway Medical Center by our Neurosurgery team since 1999.
Your son needs to be admitted the day before for MR Angio or cerebral angiogram followed by the microneurosurgery the next morning. Patency of the bypass is confirmed during surgery with ICG Vascular fluorescence. He can be discharged on day 4 after surgery but needs to be reviewed on day 7. He will be fit to fly back to Bangladesh on day 14 onwards.
Please contact my office at this number 603-74910777 (direct line) or 603-74919191 (main line ext 15519) or email: fclee.neurosurg@gmail.com.
Thank you.
Warm Regards.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Senior Consultant Neurosurgeon
Sunway Medical Center
Dear doctor,
My nephew has been diagnosed with craniopharyngioma chordoma n underwent two ops, nasal n cranium but the tumour has grown again. His doctor suggested gamma knife. I would like a second opinion n also which hospital in malaysia has this treatment.
Thank you
S ong
Dear Miss Ong,
Stereotactic radiosurgery can be performed in Malaysia using Cyberknife (Accuray USA) at Beacon International Specialist Center PJ or Gammaknife (Elekta Sweden) at Gleneagles Med Center, KL.
If the tumour is near to the optic nerve and optic chiasm as in this case, then protection of these structures from radiation is of paramount importance. In this respect fractionating the total to 5 or even 10 fractions has a distinct advantage. This is regularly done with Cyberknife and generally not possible with the Gammaknife unless of course the Perfexion model in Gleneagles has the Extend package with the vacuum assisted pillows and vacuum assisted bite block. Otherwise the Gammaknife will have to be done without fractionation, i.e. total calculated radiation dose to be given in single dose.
Thank You.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre / Beacon ISC
Dear Dr. Lee,
I’m seeking for your advise, I’m experiencing headache for more than 5 years, and now it’s getting worse, few years back the paint last for 3 to 4 hours but now it can last for 2 to 3 days. And without fail it will happen almost every week. I’m not sure what to do? I have been to clinics and hospital but they told me I got migraine. I’m seeking for treatment and hopefully it can reduce my paint. Thank you
Dear Aini
If you are confirmed to suffer from migraine, there are medications available for preventive treatment and pain control which are appropriate for your level of severity. Do request for referral to a neurologist for relief of your symptoms.
Best wishes.
Webmaster
Dear Dr. Lee,
My dad suffers from MND. I read a few websites on stem cells that could help to slower down the deterioration rate of MND. The websites that I read on was updated on 2013, stating that there were still no clear cure for this disease. May I know whether there is any form of stem cells that are recognised to be able to cure this disease? Please do provide me alot of information so that I could quickly send my dad for this stem cell treatment. I hope to hear from you very soon. Thank you very much.
Warm regards,
Michelle
Dear Michelle,
Thank you for your enquiry.
There is no definitive treatment for MND.
Stem cell treatment is considered clinical experimental treatment. At best it can only delay the progressive decline in patient’s condition as measured on the ALS-FRS scale and hopefully maintain the patient’s current quality of life at entry point of treatment for a longer period.
Yours truly,
Dr FC Lee
Consultant Neurosurgeon
Dear Dr. Lee,
I have Ankylosing Spondilitis-HLA B27 since several years ago.
On November last year, I had visited my rheumatologist due to numbness in my foot and back pain. Then I’ve done MRI on lumbar spine and Tarlov’s cysts seen in the S2 region.
I’d referred to the Orthopedic & Spine Surgery specialist and he told me the cysts is normal & accidentally appeared. He advised me to do more exercises & physio therapies.
Here are the questions for you doc
i- Is the any connection between AS and Tarlov cysts?
ii- What’s the best treatment to deal with the cysts?
Thank you doc!
Dear Mr Razy
You are advised to direct your concerns to the Rheumatologist and Spine Surgeon. These specialists would be able to provide expert advice on Ankylosing Spondylitis, rather then neuro consultants.
Best wishes,
Webmaster
Dear DR Lee,
My girlfriend was diagnosed as cystic cerebellar mass with mural nodule – possibility of cystic astrocytoma from the MRI and the only solution is surgery.
MRI scan of brain findings:
1. Cystic mass in the paravermian region of left cerebellar hemisphere measuring 4.5x4x3.5cm and showing an enhancing mural nodule on its floor. Lesion compresses the fourth ventricle though there is no hydrocephalus.
2. Normal cerebral hemispheres – cortex, white matter and basal ganglia.
3. Normal cerebral peduncles, pons, medulla oblongata.
4. Normal lateral and third ventricles, basal cisterns and subarachnoid space.
5. Normal skull vault and base.
6. Normal internal carotid arteries, vertebral and basilar arteries and their intracranial branches.
She feel headache, giddiness and unsteadiness since one month ago. Its become serious now as she feel faint while moving but nothing if motionless. I would like to check any other treatment other than surgery. How many percent is the success rate if going for surgery?
Thank you for your kind attention.
Best Regards,
Kang Ket Hao
Dear Mr Kang,
The best treatment for her cystic astrocytoma is microneurosurgery excision of the mural nodule and evacuation of the cystic fluid at the same time.
This is done with the help of stereotactic image guidance (“GPS”) through our very high definition operating microscope. It is a safe procedure and in experienced hand the overall risk is low. It leads to a long term cure if the mural nodule is removed as shown by many patients over the last 3 decades of practice.
As it is usually a low grade (non cancerous) tumour, radiotherapy / radiosurgery (Cyberknife / Gamma knife) will not help. Instead, there is a genuine concern about radiation accelerating conversion to a higher grade tumour, if the tumor mural nodule is not totally removed surgically.
Most of her symptoms are due to the mass effect caused by the fluid cyst secreted by the tumour on the surrounding brain structures. Furthermore it it helpful to know the histopathology of this tumour.
Best wishes.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Senior Consultant Neurosurgeon
Sunway Medical Centre.
Dr Lee, My wife suffer frequent headache since 2010. At present, she had headche quite severe 4 or 5 days in a week. She had CT scan on tha brain done in 2010 and recently blood test . The doctor said ‘no cause’ found. I am very worried about her problem as there is no improvement at all. I would to seek your advice whether she can have a clinical assessment done by you or neuro specialist at Sunway Medical Centre? Thank you. Best Regards, Teo.
Dear Mr Teo,
Please contact my office at Sunway Medical Centre 03-74910777 or 03-74919191 and ask for Miss Agnes / Rose for an early appointment.
Best regards.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre
Dear DR Lee,
My father is multiple brain metastasis? primary source E/A for biopsy of left frontal lesion.
Findings: multiple samples of pale looking brain tissue obtained. Sent for HPE and result will be released on beginning of Jan 2015.
MRI findings: Several enhancing subcortical lesions with marked perilesional white matter oedema.
-1.3×1.3×1.1cm (APxWxCC) : left parietal region (post central gyrus).
-0.6×0.6×0.7cm (APxWxCC) : right hight parietal parasagittal region.
0.3×0.2cm (APxW): right frontal
He posts operatively, able to ambulate and tolerate orally well. After biopsy done on Dec 10, 2014, power impressively improved on 5/5 on right side while initially only 4/5 on right side. Now power aggravated to 4/5 starting Dec 15, 2014 on left side.
I would like to check whether there is any treatment which could help him improve movement and minimize tumour accordingly?
Thank you.
Best Regards,
Allan Sim
Dear Allan,
Multiple brain metastases can be treated with radiosurgery using the frameless Cyberknife which allows for fractionation to minimize radiation side effects or using the Leksell Frame based Gamma knife which delivers the total radiation dose in one session.
Both of these offer palliative benefit and lessen the adverse side effects of whole brain irradiation.
Thank you.
Dr. Lee Foo Chiang
MBBS, FRACS ( Neurosurgery)
Consultant Neurosurgeon
Doc, I’m diagnosed as HNP on L5S1 from the MRI and the only solution is surgery. But I was advise to swim for 4 months. The pain is on the middle part of my left buttock when I walk/stand/sit for more than 29 minutes. I feel numbness on the gluteal fold. How big is the surgery to replace a disc and how to technically attach a human made disc to te vertebrae? How many percent is the success rate?
Thank you for your kind attention.
Best regsrds,
Franciscus
Dear Mr. Franciscus
You should also consider a minimally invasive Microlumbar discectomy done with operating microscope or endoscope. This takes 40 min and patient can start walking the next day and be home the 3rd day.
Thank you.
Dr. FC Lee
Consultant Neurosurgeon
Sunway Medical Center
Hi, my relative has hemifacial spasms, if she were to do a microvascular decompression, may I know the cost for this surgery?
This query has been responded to earlier.
Hi, my neck and my left shoulder are feeling painful since 2 months back. Now the pain in my neck is gone but left arm and left back start feeling painful. Pls advise! Thank you!
Dear Joey
Do consult your GP about these symptoms. You need a clinical assessment to identify the cause.
Best wishes, Webmaster
I had my csf flow done and it shows no flow at all in the fourth ventricle . Does this mean I will require surgery ??
Dear Sarah,
The absence of flow at 4th ventricle indicates that craniovertebral junction and foramen Magendie decompression is needed.
Thank you!
Dr. FC Lee
Hi Dr Lee,
My mother has been diagnosed with Atherosclerosis in the brain and shrinkage of the small brain (Celebral Atrophy) after an MRI being done in July this year. She has been taking medication since then. There are 3 types of medication prescribed, i do not have the names off hand but i do know that they are to treat her “balancing”, “dizziness” and “numbness in the limbs”. At the same time, my mum has High Blood Pressure and also taking medication to control.
The reason we went to see a Neurologist was because my mum was having constant dizziness and frequent headache. It has been about 4 months and my mum still feel dizzy 3 to 4 days in a week and still gets frequent headache. She is unable to do her usual activities like cooking for the past months and most of the time, she needs to lie down / sit down. This few days, she complains tightness of her chest.
I need your kind advise on the progression of my mum’s condition. Is it possible at all to stop the dizziness? Is there any other treatment that could help my mum? Should we get a second opinion? Appreciate if you could assist on that.
Thank you in advanced.
Dear M Lee
Your mother has a number of medical conditions, hence her symptoms could arise from several causes. She needs a thorough clinical evaluation to establish this.
Other than brain and nerve disorders, systemic diseases and ear problems may also need to be considered. At times, there may be more than one issue.
Seniors are also be prone to anxiety and depression for a variety of reasons.
Do discuss your concerns with her doctors.
Best wishes,
Webmaster, on behalf of Dr Lee
Dear doctor,i m 30.the past one year,I been having this on and off blur of vision and I start sweating with a fast heartbeat.A headache would follow suit after having that symptom.besides that,i do feel like i am floating,cant concerntrate and sensitive to bright lights.did a bloodtest and also went to Uni hospital,everything showed good result except a lil bit high on the cholestrol section.I now have the fear of driving,I can’t give my 100% towards my job and I do not know what’s wrong with me.does it have anything to do with my brain?Can you help me out as I m lost..
Dear Jason
Sorry to hear you have such troublesome symptoms. If indeed your tests at University Hospital did not show any physical illness, you should discuss with your GP whether to consult a psychiatrist, to look into the possibility of stress, anxiety or other psychological process.
Best wishes, Webmaster
Hi Dr, my father fell off from doing gym. His MRI report stated: bilateral facet joint dislocation at c4/c5 with cord compression and cord oedema/contusion. Abnormal right vertebral artery signal may represent thrombosis, sluggish flow or vascular injury/dissection.
Currently he is in ICU, Pg gh. But i would like to seek for second opinion.
I wouldn’t mind to travel over kl if need to.
Looking forward to hear from you soon.
Thank you!
Dear Charis,
Sorry to hear about your father’s unfortunate injury. He will require immediate immobilization with traction and surgical decompression and cervical spinal fixation should be done to prevent further cord compression. This can be done by either Neurosurgeon or Orthopedic spine surgeon or operating together.
Wish him all the best in his recovery.
Dr. LEE Foo Chiang
MBBS. FRACS (Neurosurgery)
Consultant Neurosurgeon.
Sunway Medical Centre
Dear doctor,
My foot is in pain for no reason as I woke up to this and I can’t even walk. This has been happening for quite sometime and I don’t exercise that frequent. Where should I go and what should I do next?
Regards, Jason
Dear Jason
You need to have a clinical assessment to determine the source of your foot pain. Do consult your GP, who may decide to refer you to the appropriate specialist if necessary.
Best wishes, Webmaster
Hi,
My son been diagnosed ADD, is there any help or option can be helped? please advise. tq
Dear Devi
ADD is managed by child psychiatrists. Please get a referral from your family doctor or check the National Specialist Register https://www.nsr.org.my/
Best wishes, Webmaster
李医生您好，我16/10/14在马六甲照MRI发现在我右脑有大约4cm的水瘤不过水瘤是黑色的但是在水瘤的一角有一小块较白蒙色的东西，所以医生担心会是肿瘤，然后医生建议做手术拿出来化验，看是良性或恶性。不过医生说年纪越大良性的机会越少。是这样的吗？
谢谢！
看起来这水瘤可能是屬于cystic astrocytoma 膠質瘤或是Hemangioblastoma. 两者都需要通过立体定向䐉外科手术切除。当然亦有可能只是一般的水瘤而己。手术安全性極很髙。是以手术显微镜進行也可以endoscope 切除。
謝謝
李富強醫生
I have just been diagnosed with chiari type 1 I have headaches vision problems and a seizure but my go says its nothing should in pursue further testing my herniation of tonsils is 7 mm in
Dear Sarah,
It may be useful to do an MRI brain CSF flow study to assess the latency if the CSF at the 4th ventricle opening (foramen Magendie) and the foramen magnum. This will determine whether you require a surgical decompression (craniovertebral junction decompression).
Thank you.
Dr LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
dear doctor i am having a seriously painful on my entire hole body an i am looking for a surgery treatment that can permanently removed this painful body pain , could you help me for this
Dear Khavishanth
We are sorry to hear of your serious symptom. However, there is insufficient information provided to formulate appropriate advice. Would you like to provide a medical summary from your doctor?
Best wishes,
Webmaster
on behalf of Dr Lee Foo Chiang
dear lee,
my son who is 13 years old has been suffering from moyamoya. doctors of appolo hospitals dhaka told me that the patient needs a bypass surgery. we have decide we will do it at sunway medical centre at Malaysia by you.
so pls make me an return email by knowing how much US dollars will be need for this operation.
regards
mr.rana
dhaka, Bangladesh.
Dear Mr Rana,
Thank you for your e-mail enquiry.
Unilateral EC / IC bypass is done at Sunway Medical Center under Intraoperative EEG burst suppression. This includes 1 day each of Intensive Care Unit and High Dependency Unit and 4-5 days in the general ward before removal of suture.
A pre operative angiogram may be necessary.
If the Moya-Moya disease involves both sides of the brain, similar procedure may need to be done on the second side usually 6 weeks later.
Thank you.
Regards.
Dr. LEE Foo Chiang
Dear Dr.Lee…
My daughter was diagnosed with Febrile Fits (July 2011), Presumed Meningitis (Apr 2012), Febrile fits (Sept 2012), Febrile fits (May 2013) & Complex Partial Seizure (July 2014). She has done her Brain EEG test in government hospital on the 15/08/2014 and just got the result on the 14/10/2014. Verbally being told that the result is ABNORMAL after the doc make a call to Neuro dept and no further explaination given as according to the doc, need to have a look at the physical report first. My daughter’s development is good and there is no changes on her attitude, study or performance. After gotten the result, the doc decided not to start any medication yet and advice for another review after 6 mnths. I am so worried and if the result is ABNORMAL, is she suppose to start her medication?…I already requested for a copy of report but it will takes about 2 to 8 weeks before reach to my hand. My concerned now is what is her diagnose and should she start with her medication?…i do appreciated for your kind advise whether she need to repeat her test in private hosp for fast action. She did not perform any MRI except for the EEG test.
Thank you.
Dear Puan Wati
Your daughter’s case needs careful evaluation of her medical history and test results, before any meaningful advice can be formulated. Childhood seizures are managed by Paediatric Neurologist. Do talk to her doctor, and if needed, a specialist referral can be considered.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Doctor,one of my aunty suffered with this kind of sick which is phemphigus foliaceus. She have been to many hospital but still not cure. Please give me any suggestion by my email. Tq doctor
Dear Syafiqah
Pemphigus is a skin condition. For information, we are specialists in the treatment of neuro conditions. Would you like to talk to the doctor who is treating your aunt about your concerns?
Best wishes,
Webmaster
Mr Lee,
I been having a cyst in brain for the past 10 years and had seizure problem too.But the doctors told me its not growing.
But lately im feeling the heat back.Feels numb and uneasy.Is there any way to remove it.Pls advice.
Thanks.
Dear Mr Chandran,
Arachnoid cyst if large enough and symptomatic needs to be removed surgically through either microneurosurgery or endoscopically, the latter to create openings in the membranous wall (fenestration).
Thank you.
Regards.
Dr LEE Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Dr lee. My father is suffering Parkinson disease since 2004. He used follow up at hospital sultan ismail jb and depends on medicine to control hand shaking. But sometimes consumed drugs ineffective. He had to take more quantity to reduce his shake. Recently, I have heard about laser treatment for parkinson. Where can I get the treatment. Or doctor has any suggestion to cure this disease. Can you respon me via email: eqnnrsln@yahoo.com
Dear Nurashikin
Thank you for your enquiry. Pleased be informed that Parkinson’s Disease is not treated with laser therapy. In fact, even moderately severe cases can be helped with adjustments to the medication. Do consult your father’s doctors about this.
In a minority of patients, PD cannot be controlled with drugs. In such cases, deep brain stimulation surgery (DBS) is considered. It is expensive and requires long term checkups to adjust the stimulator settings. This therapy has been available in Malaysia for the past decade.
For info, there is as yet NO cure for PD.
Webmaster
Dear Sir,
Having been diagnosed with a large Suprasellar Cyst in my Brain, it was decided that this should be removed sooner rather than later, so to speak. The Procedure was performed on 29 August 2014. A subsequent MRI Scan has revealed 5 Arachnoid Cysts, also in my Brain. Can you please advise whether these are cause for concern, or indeed if they will ‘shrink’ of their own accord.
Sincere and heartfelt thanks in anticipation of you reply…
Dear Miss Coulson,
Arachnoid cysts if large enough to be symptomatic need to be removed surgically through either microneurosurgery or endoscopically, the latter to create openings in the membranous wall (fenestration).
Multiple arachnoid cysts are very rare and if not causing any neurological symptoms do not require surgical intervention.
Thank you.
Regards.
Dr LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Dr.Lee,my farther in law admitted Hospital for the sick of stroke on his brain for last 2 weeks. Yesterday doctor inform me that his Cerebellum no function and now he got infection on his lung and fever. I want to know can i transfer him to Sunway medical central for treatment? you can contact me via email : canniekoh@hotmail.com
Dear Cannie
Please see your email for a personal response.
Dr Lee
My father is 79 years old and had suffered stroke twice more than 20 years and 10 years ago respectively.
In 2009, he was diagnosed by a neurosurgeon that the water in his brain is accumulated and an operation to insert tube into his brain to drain out the water to the stomach or elsewhere. However, we did not opt for the operation for him in view of his age (73-74 years old then). Moreover, he did not encounter any complication such as headache.
However, he started to feel drowsy and tends to sleep long hours during day time. So, we sent him to hospital for a MRI on this brain. The same neurosurgeon diagnosed that the water in his brain has accumulated more and there is a swelling condition in his brain. So, he suggested the operation for my father, i.e. to insert tube to drain out the water.
According to the neurosurgeon, the operation is not a major operation and only a little hole will be opened to insert the tube. The risk of operation is as low as 1%.
In this regard, I would like to seek Dr Lee’s consultation and advice on the risk of the operation. Would the operation be suitable for my father who is so old now and would the recovery be difficult for him who had suffered stroke twice.
Your consultation and advice are truly appreciated.
Thank you.
Regards
Ms Choo
Dear Caffy,
Ventriculostomy-peritoneal shunt is indeed a neurosurgical operation which generally takes 30 min to 1 hr. It is necessary to differentiate between hydrocephalus ex-vacuo whereby CSF accumulates in the cavities of the brain due to shrinkage of the brain tissue with age or normal pressure hydrocephalus due to suboptimal CSF (fluid) absorption in the presence of a normal CSF production.
The former will not benefit from a VP shunt.
The latter has a classical triad of symptoms namely gait disturbance ( dyspraxia ), loss of urine control (incontinence) and memory loss.
Best wishes.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Dear Doctor Lee
I am writing in from Labuan, Federal Territory.
On 19/09/14, I send my 8 year old son to an eye specialist in Kota Kinabalu, Sabah.
The eye specialist, Dr. Peter V.Y. Kong, diagnosed my son’s condition having Bilateral Optic Atrophy.
He recommended that an MRI be done on my son immediately.
The result of the MRI done by KPJ Sabah as follows:
1. Large sellar-suprasellar mass 5×4.5×3.5 showing enhancement and a central cystic component. Lesion compresses the optic chiasm and elevates the floor of the third ventricle. There is no hydrocephalus.
2. Normal cerebral hemisphere, the cortical grey matter, the white matter and the basal ganglia.
3. Normal cerebral, pons, medulla oblongata and the cerebellar hemispheres.
4. Normal skull vault and base of skull structure.
IMPRESSION: MRI features suggest a large craniopharyngioma causing severe chiasmal compression.
We took the report back to the eye specialist and immediately Dr. Peter V.Y. Kong referred us to you. We are very worry about our son’s condition. Please advise us what is the next course of action. My email address is: fong129@gmail.com.
Thank you and our best regards.
Lawrence Fong
Dear Mr Fong,
The large craniopharyngioma is best approached via a craniotomy and removed piecemeal microsurgically. This will immediately decompress the optic nerve and prevent further damage to his eyesight.
Surgery may take 3-4 hours and he needs to be warded for 4-7 days.
Thank you.
Regards.
Dr. LEE Foo Chiang.
Consultant Neurosurgeon
Sunway Medical Centre.
Hi Dr Lee,
My brother has been diagnosed having Trigeminal Neuralgia since 2 years ago. Planning to do microsurgery decompression in KL or Penang. May I know how much does the surgery cost? My email is ms_m3l1na@yahoo.com Thanks, Melina.
Dear Melina
Please see your email for a personal reply.
Best regards.
Hi Dr. Lee, I was diagnosed of having Bell’s Palsy 5 days ago and currently having physiotherapy with heat therapy and electric stimulation therapy. The physiotherapist also asked me to do some facial exercises which seems futile as my affected face wasn’t moving at all. Some of the patient in the forum advice me to stop the exercises as well as the electrical stimulation which they said will damage the nerves further which contradicts with what the physiotherapist said. I am so confused now, please advice on what should I do in the current state. Thank you.
Dear Eric
Facial exercises are a beneficial adjunctive treatment in addition to medication in the case of Bell’s palsy. There will of course be no visible benefit in the early stages but the neural system is being modulated.
As for electrical stimulation, there are differing views on its benefit. There has been no evidence of it causing harm. In case of doubt, do refer your questions to your doctor.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Dr Lee … 我的家人昨晚才刚开了minor operation 去除 brain tumors. 他在昨天早上八点多进行了手术，过后在下午就醒过来了。手术成功。可是今天他开始说话反应有点慢，也说不准。请问这样的反应是正常的吗？是因为手术的药物还没退吗？
Tumors 拿去化验了。如果报告显示的是良性，那接下来病患应该注意些什么？如果是恶性呢？
Dear Cindy,
你家人所进行的所谓minor surgery 应该是抽取腫瘤样本作切片化驗。手术过后的可能反应该会包括腫瘤出血，水腫及細菌感染。這些都是很罕見，但卻可導至手术后病人反应迟顿。不妨要求主治医生作䐉扫描，以作適当处理。
谢谢。
李富强医生。
Dear Dr,Lee,
Greetings.
My dad is suffering from hemifacial spasm for almost 3 years now. He’s 59 years old and I would say he’s been going through a tough time. His left eye twitches non stop. This affects his vision and there’s a difficulty in eating as well since his mouth sometimes follows the movement of his eye. He had medical treatment done (botox injected) for quite some time. But it doesn’t help. He even tried ayurvedic treatment as some people advised since it has got something to do with nerves. It refuses to go away. He’s just living with it now and it causes so much of uneasiness to him.
I’m seeking your kind advice from your good self.
Thank you.
Praveen
Dear Praveen
The treatments for hemifacial spasm (HFS) consist of medications, botulinum toxin (BTX) injection and finally, microvascular decompression in the case of failure of the first two options. Currently, BTX is the most widely used treatment for severe HFS. You should be aware that the benefit is not permanent; usually repeat treatment is needed after every 3-6 months or so. Do discuss with his specialist as to how he can obtain relief from proper administration of BTX.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Dear Dr Lee,
My father, 55 yrs old, has got Parkinson for the past 10 years and used to follow up at Hospital Kuala Lumpur. Currently, he is on medication and body patch given by HKL to control his shaking hands and stiffness. Do you have any advice or updates for him in terms of medication and treatment? Is there anything else we can do for him? What about the deep brain surgery? Is it effective?
Regards
Lim
Dear Mr Lim
Your father has young onset PD. Treatment consists of medication adjustments suited to his requirements. Deep brain surgery (DBS) can be considered when the condition cannot be controlled with medications. It is effective in carefully selected cases.
As such, your father should have a detailed discussion with his specialist about his current and future options. If DBS is proposed, he needs a thorough assessment to confirm its indications and to determine his fitness for surgery.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Dear Dr. Lee,
We are seeking a better management for our father. 75 years old, gentleman post traumatic head injury (bilateral subdural hemorrhage) on 30/6/14, right craniotomy and left burr hole done on 7/7/14. Currently alert, conscious, speech is slurred and bed bound. He is on Ryle tube feeding and Upper limb power 4/5, lower limb power 2/5.
As he is still in hospital, thus we would like to call you personally to discuss in detail. Please advice.
Thanks & Regards,
Ying
Dear Huey Ying,
Please call my office at Sunway Medical Centre +603 74910777 or ANOC +603 2282 6113 for an appointment. Please bring along his CT Scan or MRI brain and medical report if available for a more meaningful discussion.
Thank you.
Regards.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
Hi, Dr. Lee
My name is mona and im 36 years old. i have spine split disc, L1 & L4. Now im going for fisio therapy for strecting my spine. now my pain is getting worst and worst until i cannot sleep straight. Can i do laser surgery and is the safe for me to do. Can you advise me ?
Thank you
Mrs. Mona
Dear Mrs Mona
It appears that you have prolapsed lumbar disc which requires some form of definitive treatment. It will be necessary to look at your MRI lumbar spine apart from assessing you clinically before a decision can be made.
Thank you.
Dr. LEE Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre.
Dear Dr. Lee Foo Chiang,
My mother in law was admitted to the hospital on 17 Jun 2014 in ICU for 3 weeks and currently switches over to general ward for nearly 4 weeks. She never regain consciousness in between, experienced prolong fever until today.
History:
On 17 Jun 2014, she fitted 3 times at home (never fitted before), first time at 1am last 5mins, then at 2am also about 5mins and last at 5am lasting about 15mins, associated with uprooling eyeball, no drooling of saliva, no bowel or urinary incontinence. However she never regain consciousness in between, all spontaneously aborted. She is admitted to the hospital immediately and experienced another fitting, GTC, uprooling of eyeball, drooling of saliva, followed by bowel incontinence.
GCS E1M3V1, pink, warm peripheries, CRT <2s
Pupils: sluggish equal, bilaterally. Elective intubated at about 0720H, 17.06.2014
1. ETT size 7.5, anchored @ 21cm
Pre meds: IV fentanyl 100mcg, IV midazolam 5mg stat, IV scalene 100mg stat
2. POST intubation: SpO2 99, loaded with IV Phenytoin for 1 hr
Medication:
1. IV Merophenem 2g TDS
2. IV Phenytoin 100mg TDS (Patient allergy causes Pemphigus)
3. IVi Sodium thiopentone 10mg/min
4. IV Sodium valproate 600mg BD
5. Oral Keppra 500mg BD
6. IV Phenobarbitone 100mg BD
Background:
She is well all this while, but a week ago, started on 12 Jun 2014 she experienced lower back pain and lethargy, she went to Hospital Tong Shin and X-ray result done was normal, discharge with mecoabalamin, etericoxib and orphonedrine. She took the medicine until 15 Jun 2014 and she claimed that the pain reduced after taking medications but having ear pain and headache. Other than that, no prolong fever, no neck stiffness, no anormal behaviour, no history of one sided weakness, no history of trauma to the head, no UTI/URTI sysmtoms.
Impression:
1. Status epilpeticus 2’ meningoencephalitis
2. CT brain (17.06.2014) – No significant abnormalities detected. No ICB.
3. CT brain contrast 21.06.2014:
– No focal enhancing brain parenchymal lesion or abnormal leptomeningeal
enchancement
– Culture CSF – Final No Growth
– CSF protein: 0.9
– CDF glucose: 5.5, dxt: 8.8, opening pressure not done
– CSF Bact Ag – Negative
– Blood Culture – NGD1
Treatment History:
1. Treated for Enterococcus Faecalis bacteria
2. Covered for meningoencephalitis
3. Resolved AKI
4. Treated for Clostridium Infection – Negative
5. Drug induced bullous pemphigoid – Resolved
Antibiotic History:
1. IV Ceftriaxone 2g BD – 06.07.2014 completed
2. IV Meropenem 2g TDS – 08.07.2014 completed
3. IV Acyclovir 500mg TDS – completed
4. IV Tazocin 4.5g QID
Tests:
18.06.2014 Lumbar Puncture – Normal Study
24.06.2014 Abnormal EEG with generalised epileptiform discharge with burst suppression
and diffuses cerebral dysfunction
02.07.2014 Abnormal EEG with burst suppression throughout the tracing, absence of
background activity during interburst interval
07.07.2014 CT Brain Scan with contrast – Normal Study
23.07.2014 NMDA rough activity – Negative
Current Medication for anti epilepsy
1. Syrup Sodium Valproate 600mg
2. T Keppra 1.5g
3. T Clonazepam 1mg
P/s: Suspect the prolong fever is affected by the brain
Currently the doctors are unable to determine the actual reason behind. Can you please give us some advice?
Your kind assistance and earliest reply are very much appreciated. Thank you.
Best Regards,
Adex Chia
Dear Adex
For info, Dr Lee is away. Looking at your relative’s complex treatment progress, it is not likely any meaningful advice/recommendation can be given without examining the patient and studying all the relevant scans and results. Do discuss with her doctors about further measures. If there is still uncertainty, you could consider asking for a 2nd opinion.
Best wishes.
Webmaster, on behalf of Dr Lee Foo Chiang
Ct scan normal . However escalated loss of frontal brain since last scan in 2006 to now 2014 . I suffer daily blackouts . Affects my life greatly . My memory isn’t the greatest . Doctor did small test 7 out of 10 . I forget to my surname . Address . Dates . Day it is . I’m a 50 year old female . Going to see neurologist for further investigations . Why has ct scan not detected why I have blackouts ? Why loosing braincells faster than I should be ?
Dear Ms Pearson
Your symptoms need thorough evaluation by Neurologist, followed by appropriate investigations. Thereafter, there should be sufficient information to advise you on the diagnosis and the necessary treatment.
Best wishes.
Webmaster.
Dear Dr. Lee,
I have an emergency situation. Three weeks ago, my sister in law did the MRI test for her head, because almost nearly 2 months she headache continuously. The MRI result says there’s Colloid Cyst in her brain. We will arrive in Kuala Lumpur tomorrow, we have an appointment with neurosurgeon in one of hospital in KL. my question is, how can I make an appointment with you and bring my sis in law to be checked ? Please kindly your advice.
Dear Febby
Please contact Dr Lee Foo Chiang’s clinic – details in the Contacts page.
Best wishes.
Webmaster.
Dear Doctor Lee
My mother 65 years old, from Alor Setar suffer with Trigeminal Neuralgia more than 3 years. Earlier on she take medications such as Carbamazepine and Pregabalin. But over the pass 4 months her condition become more serious, the medicine can help to relieve pain.
I found the surgical named below online.
iCT and CT-guided percutaneous radiofrequency trigeminal rhizotomy
Microvascular Decompression (MVD)
Would like to know any other option for my mum case. Any risk for this surgical for my mum aged 65. How much for the medical cost for this surgical.
Thank you.
Piek Ying
Dear Miss Yam,
Radio frequency rhizotomy is basically using radio frequency to “burn” the Trigeminal nerve. It is in a way a “destructive” procedure.
It can lead to anaesthesia dolorosa with loss of facial sensation and more dangerous, ulceration of the eye cornea with loss of sight in the worst case.
In contrast Microvascular decompression (MVD) microsurgery or with endoscope is a regularly performed “physiological” procedure and in safe hands has an overall risk of not more than 1-2%. It leads to relief of facial pain and recurrence is the exception in my experience. It has been practiced in this country for the last 30 yrs.
I hope this helps you make an appropriate decision for your mother.
You may want to talk to some patients who have undergone MVD.
Warm Regards.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre.
Hi doctor, my mother has severe nerves pain on both of her hands, she can’t even open the cover of a water bottle. the condition become worse in the early morning, may i know whats the medical problem she faces?
Thank you so much.
Dear Jenise
Your mother needs a clinical assessment by her family doctor to determine what is the source of her pain. Possibilities include rheumatic, orthopaedic and neurological conditions.
Best wishes.
Webmaster.
Dear Doctor Lee,
My brother in law’s medical insurance application was rejected due to to diagnosis made as follows: demyelinating polyneuropathy, high protein content in urine, and low thyroid reading. The insurance agent advised us to see an orthopedic to treat his neuro problem soonest possble but we ignored.within a week my brother in law cannot walk, must rely on walking stick and assistance from my father in law, the numbness in limbs seems to spread to his tongue. Should we bring him to see an orthopedic or an neurosurgeon?
Dear Ming
We recommend that your relative should consult the doctor(s) who made diagnosis of demyelinating polyneuropathy, to determine whether the new symptoms are also due to this condition or alternatively, he has a separate illness.
Best wishes.
Webmaster.
Dear Dr Lee,
I am suffering migraine during menstruate for many years. Recently it is getting worst as the period of the pain is getting longer.Sometimes it can be up to 4-5 days. Please advise what should I do in order to reduce the pain.
Dear Canness
You should see your doctor to assess why the menstrual migraine has worsened. Causes could be hormonal or lifestyle factors, as well as the development of another (separate) medical condition.
Webmaster.
Dear doctor,
My dad have a bone spur on his foot,we went to Kota Kinabalu and have an injection,but still same problem,which doctor should I meet?
Dear Joanne
You can consult an orthopaedic surgeon.
Best wishes.
Webmaster
Dear Dr. Lee,
My husband has been experiencing severe pain at his neck area and back head, and if the pain is severe, he will experience photophobia, nausea, shivering and generalized bone aching. Apart from these, he also experiences body stiffness, weakness on left hand & shoulder as well as muscle tremor.
He used to take 1-2 tablets of Tramadol (prescribed by Dr) to suppress the pain but lately he needs to take 10-12 tablets daily to suppress the severe pain. He had previously done CT, MRI and everything seems fine except that DR has once diagnosed him with osteoporosis at the hips. However, no treatment was recommended except the prescription of Tramadol.
When he was admitted to hospital last year due to high fever, he had done MRI and he was diagnosed with acute myositis with acute neck/muscle sprain, mild disc bulge C4-C6 and L5/S1. Based on the result the ortho said nothing major but my husband is still experiencing the pain until now and in fact it’s worsening. Recently, he had done a PET/CT Scan and no tumor or cancer is detected but the Dr found out that there is abnormal appearance of his C2 bone (C2 bone is split) and unusual space is detected at his celleberum. The Dr has advised to further study by doing a MRI at these 2 areas.
We are unsure of the specialty that we should go for, ortho or neuro? If neurology, shall we go for neurologist or neurosurgeon and what would be the possible diagnosis? We would really hope that Dr. Lee will be able to provide some advice. Appreciate it.
Thank you in advance.
Regards,
Soo Mei
Dear Miss Soo Mei,
I think your husband needs a thorough assessment by a neurosurgeon including MRAngio. Review of the earlier MRI cervical spine is necessary. Apart from the possibility of cervical spine problem with neural compression, exclusion of sentinel bleed from aneurysm warrants exclusion.
Thank you.
Dr. LEE Foo Chiang.
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Dear Dr. Lee,
Thank you for your valuable advice. We have made an appointment to consult you in your office tomorrow.
Hope you will be able to help him. Thanks.
Regards,
Soo Mei
Dear Dr Lee,
i recently got my wisdom tooth removed, and on the same night after the surgery, i feel that part of my tongue still numb and uncomfortable,within the same week, i went to see the dentist again, and she said my nerve could have been hurt during the extraction process, and she said that my tongue will recover naturally after ap month. i would like to confirm if what she told me is real, or do i need to get my tongue check by a specialist ?
Dear Eric
It is not possible to comment without a complete set of the clinical information. You are best advised to follow up with your dentist. If not recovered after the prescribed period, you could request for second opinion.
Best wishes.
Webmaster
Name: Lisa Leow
Email: lyllisa@yahoo.com
Website:
Message: Dear Dr Lee I am 42 yrs old. I recently went to see a neurologist 3 days ago on 23 may 2014, to find out why I keep getting aura, zigzag and vision loss. No pain. Did an MRA which showed minor narrowing of intracranial right NICA. Saw eye dr upon recommendation of my neurologist and was diagnosed with Fuchs distrophy in both eyes but the eye doctor said it is unrelated to my aura…etc. my nephew (8 yrs) and niece (13 yrs) both hv been diagnosed with moya moya. I was given Cardiprin to be taken indefinitely and Amitriptyline to be taken for two weeks. I am worried and would like to seek a second opinion on whether this is the right treatment for me and whether the medication prescribed takes into account my Fuchs. I also hv slightly low blood pressure of 100/60 and hv never been able to donate blood as I was informed I was anaemic.
Dear Lisa
You may wish to consider consulting Dr Lee Foo Chiang for opinion concerning your MRA findings and any possibility of Moya Moya disease. His clinic address is provided on the website.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Hi Doctor,
My dad has a fat tumor at left chest wall, is this a lipoma? we are looking for respective doctor for further examination and treatment, is this the right place we are looking for? thanks
Dear Miss Lim,
He should see a general surgeon or cardiothoracic surgeon.
Thank you.
Dr. LEE Foo Chiang
Consultant Neurosurgeon.
Hi Dr Lee,
I’ve had three spinal surgeries over the course of three years, l5-s1, acdf for c4-5 and c6/7. After my last operation, I find my symptoms aren’t getting better, in fact, I’m worse now. I have checked it out with doctors, they don’t seem to think it’s the surgery but perhaps a syrinx in my spinal cord could be causing all my symptoms. However, I’m told that the syrinx, which extends from c3-c7 is not large. It has grown tho, slightly from previous scans.
I’m in constant pain. Pain that makes it impossible to sleep, my neck is always very stiff even tho I diligently do my neck exercises, my left arm is always painful near the biceps, n there is marked weakness on my grip, and I frequently drop things. I also suffer from memory loss, unable to totally empty my bladder, and a few days ago, I developed breathing issues, whereby i’d be sleeping but can’t seem to breathe. Sometimes I have trouble swallowing saliva. I’ve been on a host of medications from gabapentin to duloxetine, even opioids to relief pain but it doesn’t go away nor does it help with my weakness on my left.
If there’s anything you can do, please help me. I am terrified of the prospects of being paralyzed. Thank you in advance.
Dear Mrs Kumar
It appears you have a severe and complex problem in spite of multiple surgeries. Therefore, it is not feasible to provide meaningful advice without detailed assessment and understanding of your treatment history.
Your best option is an in-depth discussion with your doctors. We note that you are already taking various pain medications; perhaps referral to a Pain Specialist could be considered.
Best wishes,
Webmaster
on behalf of Dr Lee Foo Chiang
Dear Dr.Lee,
im 25 years old women, suffering with migraine. Nowadays the symptoms tend to worsen by vomiting. Can you help me to suggest for my problem. Thank you. Regards Mala.
Dear Mala
You are advised to consult a neurologist. There are effective rescue as well as preventive medications for migraine.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Hello Dr. Foo,
I found your website upon researching online for clarity about my condition. My name is Qistina and I’m 22 years old, I have been experiencing migraines/headaches that are intensifying in terms of pain and frequency.
A little history that I feel that could be relevant is that I’ve experienced quite a number of head injuries on numerous occasions:
3yrs old/ 8+yrs – Involved in 2 car accidents in which my head made hard impact with the car handbrake/ the hood of a van.
10yrs onwards – Incidents which include; head on impact with football causing me to blackout for a few seconds and a nosebleed, the steel pole of a basketball hoop falling on the top of my head, futsal ball in contact with front/back and side of head, and numerous accounts of falling forwards and backwards with my head in contact with concrete.
Note also that I have been experiencing frequent nosebleeds from the age of 9 till about 18, in which I have sought treatment and have been diagnosed with a slightly deviated septum (suspected to be the result of the car accidents)
Regarding my headaches/migraines;
They escalate in intensity depending on different situations i.e. stress,loud sounds/voices, sudden changes in weather/temperature, hot/humid environments, bright natural/artificial lighting and even waking up too fast.
The pain experienced varies from allover pressure and throbbing during milder cases, and intense sharp pain on the front,side and back of my head coupled with radiating aches throughout my face, jaw, neck and back on more serious cases. There have been some accounts where I have experienced being “knocked back” to my seating position while standing up due to the sharp pain.
I do hope you can shed some light on my condition and if its possible for me to book an appointment with you.
Thank you for your time, I hope to hear from you soon.
Regards, Qistina Ruslan
Dear Miss Qistina,
Thank you for your e- mail.
Although most so called “migraines” are idiopathic without any underlying cause nor related to head trauma, headaches of increasing degree of severity or frequency warrants investigation with a CT or MRI Brain scan to rule out the rare incidences of say tumor or other space occupying lesions.
Most headaches however are “benign” and requires just symptomatic treatments.
Regards.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Center
Dear Dr Lee,
My son( 9 months old now) was diagnosed to have suprasellar arachnoid cyst since birth. In fact, we knew it since I was 24 weeks pregnant, by routine ultrasound by my O & G. At 3 weeks old, he had an MRI which showed the suprasellar cyst ,size 2.7X2.6X3 cm , causing superior displacement of optic chiasm and splaying of midbrain, no hydrocephalus. Now at 9 months, his rpt MRI showed slight increase in cyst size- to about 3X3.4X3.2 cm and also mild dilatation of 3rd ventricles and lateral ventricles, other than the local mass effect on optic chiasm and midbrain. My son is growing well, and developmentally normal.
We just saw his neurosurgeon. Plan was rpt MRI at 1 year and KIV op- endoscopic cyst fenestration. Can i consult you, in KL, who’s the best neurosurgeon in this kind of operation, as it is an endoscopic procedure… I’ll appreciate if you could recommend who you think best in management in such case…thanks..
anxious mum
Dear DeZhuang,
Endoscopic cyst fenestration for children is generally done by Pediatric Neurosurgeons. There are a couple in University Malaya Medical Centre.
Thank you.
Dr LEE Foo Chiang
Consultant Neurosurgeon.
Sunway Medical Centre.
Dear Webmaster, I would like to get second opinion for my dad, neurosurgeon suggested him to undergo Posterior Lumbar Interbody Fusion for neck and lumbar. I would like to get a quotation if possible. I can send you the file of his recent MRI. Can you please let me know which email address to contact you. Thank you
Jenny
Dear Jenny
Lumbar and cervical surgery are both complex operations for a senior like your father. Discussion about potential benefit, feasibility and safety requires a thorough clinical assessment of the spine as well as his general health. We would like to suggest that you seek a second opinion from a surgeon who is able to provide clinical evaluation.
Best wishes.
Webmaster
Dear doctor Lee,
My father who is 44years old is suffering from neck pain for a three months.He believe that the pain start from the left neck until the left hand.Sometimes,he feels numbness on his left hand by a half an hour.He have done MRI scan and confirmed by doctor that he having POTRUSION DISC on his neck.He also have done accupuncture ,massages from some center but the pain is still same to day by day my father searching for treatment that without surgery.Kindly,please doctor advice.Thank you.
Dear Shasveena
It is not possible to provide meaningful advice without detailed understanding of your father’s condition. Do please speak to his doctors who are in the best position to counsel you.
Best wishes.
Webmaster
Dear Miss Shasveena,
Dr Lee Foo Chiang has the following recommendations for your father:
If medical treatment is unsuccessful, cervical disc protrusion in 44 yr old causing neck pain, arm pain and weakness from nerve root compression can be treated with anterior cervical discectomy, and/or artificial disc replacement by neurosurgeon.
Thank You.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Dear Dr. Lee,
My father is admitted to university hospital petaling jaya he is at the menara selatan level 9.Mr.katamuthu with stroke .He cant recognise us he is talking to him self …can you advice me on this ..can he recover and what is the status .
Regards
Mathy
johor bahru.
Dear Mathy
It is not possible to provide meaningful advice without detailed understanding of your father’s condition. Do please speak to his doctors who are in the best position to counsel you.
Best wishes.
Webmaster
DR 请问您的医院有做Awake craniotomy这个手术吗？谢谢！
Dear Christy,
We have done awake brain surgery since 2003 when we started the first Deep brain stimulation for Parkinson’s disease in Malaysia.
Awake brain surgery was also done for brain tumour resection in sensitive areas of the brain more than 5 years ago.
For info, the ASIAN Congress of Neurosurgery 2010 the Pre-Congress Training Workshop for “Awake surgery on brain” was conducted in Sunway Medical Centre for the teaching of neurosurgical delegates from all over Asia.
Warm Regards.
Dr. LEE Foo Chiang
MBBS FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Hi Dr Lee,
i have all the symptom of (MSA)Multiple System Atrophy, but currently as per research done in internet, i couldn’t find any diagnosis to confirm this disease. i have done MRI scan on my lower back and confirmed by doctor that i am having slipped bulging disc on my L4 and L5. Recently done neck MRI, but everything looks fine there. can u suggest any other diagnosis to confirm whether i am having this disease or not? because am having the symtoms more than 8 months now currently it is getting worse day by day. need to confirm this urgently because as per information given the life span of the sufferer will only last 6-7 years. i am male and 35 now.. TQ
Hi Said Alwee
You should discuss with your doctor about your diagnosis, and whether it is at all likely to be MSA, which is a rare condition. The diagnosis is based on a set of clinical criteria, supplemented with imaging information. If in doubt, your doctor may refer you to a neurologist for expert assessment, so that your worry and concerns could be resolved promptly.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang, Consultant Neurosurgeon
Dear Encik Said Alwee
MSA is diagnosed by a set of clinical criteria. There is no diagnostic (confirmatory) test. Therefore you are advised to see a neurologist for proper assessment and diagnosis, and to consider alternative causes for your symptoms.
For information, in recent years it has been noted that there is a wide range of severity for MSA, and mild cases do much better than previously predicted.
Best wishes.
Webmaster
Dear Dr Lee,
Any surgical intervention for phantom limb pain post AKA for chondrosarcoma done in year 2000. Currently on Lyrica 150mg bd with no improvement.
Dear Usha
You can consider consultation with a Pain Specialist. Most major hospitals in the private and public sector provide such expertise.
All the best.
Webmaster
Dear Dr Lee,
My father (75 years old) was diagnosed with :-
(1) moderately severe spinal canal stenosis throughout the lumbar spine secondary to lumbar spondylosis
(2) L4-L5 spondylolisthesis causing severe spinal canal and bilateral foramina stenosis, and compression of the L4 nerve roots.
No sure we should see neurosurgeon or spine surgeon ? 以上病况是指什么病（英文及华文）？
Thank you.
Soo
Dear M Soo
Your father is a senior and the condition appears to be serious. He needs an experienced and skilled surgeon. Both neurosurgeons and spine surgeons conduct such operations. You should consult with your father’s doctor to discuss the technical expertise of the surgeons available. Please note that good medical and anaesthetic support are equally important for his safe surgery and recovery.
Best wishes.
Webmaster
On behalf of Dr Lee Foo Chiang
Dr Lee,
My sister has been recently diagnosed with idiopathic syringomyelia. Her symptoms are progressing. We have seen a number of Neuro surgeons over the past year saying she has a prominent central canal. The latest believes she has idiopathic syringomyelia. We are waiting to see another Neurosurgeon referred by a rehabilitation hospital in Sydney. What are the best treatment options for this diagnosis in your opinion. Many thanks Paul
Dear Paul,
Idiopathic syringomyelia if symptomatic can be treated variously with simple syringostomy, with / without craniovertebral junction decompression if associated with cerebellar tonsillar herniation (Arnold Chiari Malformation) and syringo-peritoneal/ pleural shunt in severe or recurrent cases. Small a symptomatic syrinx is usually left alone but monitored clinically and with MRI regularly.
Thank you.
Dr. LEE Foo Chiang
MBBS FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Malaysia
Dear Dr Lee ,
My son who is 19 years old is suffering from upper back pain for a week . He belives the pain starts from the right neck area to the upper back .He feels a pain and a burning sensation in the back area which last throughout the day .We believe it could be a pinched nerve in the neck .kindly advice
Dear Mr. Selva,
Thank you for your e-mail.
Your son obviously needs a thorough neurological assessment by a neurologist / neurosurgeon. MRI of the cervical and thoracic spine is essential. The former must include craniovertebral junction. There remains a few possibilities for the underlying cause of his pain and will include musculoskeletal, pinched nerve by disc herniation, spinal or nerve tumor, cyst (syringomyelia) within the spinal cord.
Warm Regards.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Dear Dr Lee, my aunty complaint serious headache last Tuesday. We sent her to hospital. unfortunately. she turned coma and couldnt breath herself the next day. Doctors found that the vein in the brain break and the blood clot inside. A major surgery was done to remove the blood clotting and the surgery considered successful. However, now she is still coma. We are so worry is when she will wake up? Dr Lee can you please advise on this?
Dear Winne
We are sorry to hear of the lack of response of your aunty. It sounds like her situation is complex and difficult. Her doctors would be in the best position to advise on the treatment and expected outcome. Do discuss your concerns with them.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
i wish to check as i do have frequent back pain especially around my back neck area. The pain are getting worse recently and have affect my sleeping. If i wish to do MRI, can i claim using my insurance card?
Dear Ms Teoh
We are sorry to hear you have a back problem. Claims for medical tests are based on the conditions stated in your insurance policy. Do check with your insurer.
Best wishes, Webmaster
Dr. Lee,
你好。 請問為什麼 after burr hole surgery 會有暈眩的問體，不能有太大的動作。手術是二年前，目前都在服藥。非常感謝！
Dear Esther,
晕眩不一定和burr hole 有关。導因有几个，包括䐉血液流通不顺畅，耳朵平衡神經失調等。須近一步檢查。
謝謝。
Dr. FC Lee
Thanks a lot !
Dear Dr. Lee,
Below was my MRI findings:
1. Multiple bilateral perineural cysts (right more than left) at L5/S1 and S2 exit foraminae.
2. L4/L5 disc degenerative disease with mild central disc protrusion.
I would like to know is that any treatment can help?
Dear Miss Hew,
You should benefit from Microlumbar / endoscopic discectomy. The peri neural cysts may be excised at the same time if they are sizable and causing symptoms.
Warm Regards.
Dr. LEE Foo Chiang
Consultant Neurosurgeon.
Sunway Medical Centre
dr lee
i have spinal cord injury at c5 and c6, and i cannot move from shoulder to down, what kind of healing i can do? thanks
Dear Mr Affin.
Stem cell treatment has been used for spinal cord injury on a clinical experimental treatment with promising results. This has also been carried out in USA and UK.
Good luck.
Dr. LEE Foo Chiang.
Consultant Neurosurgeon.
hello doctor. my name is poorneema. i been suffer headache since when i was in college. one day i was in class suddenly i fainting with my eyes opened and then the second time is in house. 3rd is my eyes were blankout. can you check it out whats my problem?
Dear Poorneema
You are advised to get a clinical evaluation, firstly by your family doctor, so that the problem can be identified. Blackouts may be due to neuro or other system disorders.
Best wishes, Webmaster
My daughter is 1 year and 2 months old and She had a brain hemorrhage on 14th March and has been in hospital since then. Get latest MRI results suggest that she had a covernous malfunction (cavernoma). We seek your advice regarding her surgery, we are currently in Pakistan and can travel for her treatment, if you can kindly provide us consultation.
Please contact me on my email so that we can discuss this further.
Thank you.
Dear Mr Sultan,
I am sorry to hear about your child’s problem.
Most cavernomas can be resected successfully using micro neurosurgery with image guidance stereotactic (surgical “GPS”).
Once the cavernoma is resected, there is no risk of further bleeding. Overall surgical risk is 1-3%. Some of the disability from the bleed can be reversible after evacuation of the clot.
Surgery generally takes 3-4 hours and 4-7 days of hospital stay including 1-2 days in Intensive Care Unit.
Feel free to contact us if you like your child to be treated here.
Warm Regards
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Neuroscience Services
Sunway Medical Centre.
Selangor, Malaysia.
+60374910777, +60374818191 (International Patients Services)
fclee.neurosurg@gmail.com
Dr. Lee,
Thank you for your reply. We have came to your clinic last week. We will consider to have another MRI scan on the cervical spondylosis that you have suggested.
Have a good day. Sincerely thank you again for your response.
Hi Doctor Lee,
If I want to do the MRI Scans, do I need to make appointment? or direct walk in? (sunway medical center)
Hope can get your reply soon…
Best Regards,
Ngo
Dear Ngo
Scans and other tests are generally ordered after a consultation. This will ensure that only those which are appropriate are done, in the interest of the patient.
Best regards, Webmaster
Dear Dr Lee,
My father is 71yrs old and just 3 days ago he was admitted to the hospital. From the CT Scan he was informed that he has inflammation in the blood vessel. Later did a MRI scan and the image was cleared and was discharged with just some painkillers. He still feels dizzy at times and constant headache. Before his right eye has been twitching for years. Dr Lee, could you please kindly advise me what else or who else we could seek help. Is there any anti inflammation medication to prevent the condition to get worst?
Looking forward to your reply.
Thank you in advance.
Jess
Dear Jessica,
Please see your email for a personal response.
Dear Dr Lee Foo Chiang,
Appreciate if you could advise due to my mom who had gone through her 5th and 6th spinal cord surgery last 2 years as she felt the pain and numb on her hand while holding something, now she’s having back the same problem which i dont know why it is coming back again after 2 years, we did brought her for X-Ray scanning and was said that she need to go through another surgery to avoid paralyse. I wish i could bring her for your consultation, which is much more preferable to go over your clinic or sunway medical centre ? Because we are coming up from Johor.
Dear Ms Oh
Please see your email for a personal response.
Best wishes.
Hi dr. Seek your opinion. My daughter now 6years old having a bump behind her back. A dr did mention the word lipoma. Then after i google the word on web… found that lipoma only happened to older people, not to children. Does it possible that a 6 years old child have this lipoma? Most of the dr i visited suggest dont do anyhing to it because the bump doesnt cause any pain to her. May i have your comments on this matter?
Dear Ms Maria,
I presume the lump is over her low back.
It may be a subcutaneous lipoma which in some cases overlies a spinal bifida (congenital split back element of the vertebra).
This can be confirmed on MRI lumbar spine which is a non invasive scan with no radiation hazard to the body. It is important to exclude this as it may be associated with similar lipoma within the spinal canal and can stretch the spinal cord downwards causing problem with urination and lower limbs (tethered cord syndrome) especially around puberty years.
Thank you.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
Dear Dr Lee,
My mother age 54 has been suffering twitching below her right eye and cheek area for a few years. The movement got more frequent and now it even cause numbness and she could not sleep at night. May i ask for advise what illness this could be and can it be treated?
Dear Stephanie
Firstly, our apologies for the delay in response – your comment was caught in the spam filter.
Causes of twitching around the eyes include myokymia, hemifacial spasm and blepharospasm. Your GP would be able to advise on first-line treatments. If there is no response, you would be advised to see a neurologist for opinion and treatment.
Best wishes, Webmaster
Dear Dr.Lee,
My father has developed unwanted movement in his face & eyelid for several years now, and his initial diagnosis is hemifacial spasm.
Do you have any experience in this problem, and how much does it cost for a surgery to Cure it permanently ?
Thanks for your time
Dear Mr Tatum,
Microvascular decompression (MVD) surgery for hemifacial spasm (HFS) and trigeminal neuralgia is done regularly in my practice. It is a rewarding and elegant operation with excellent relief of HFS and trigeminal neuralgia immediately post operation.
Please see your email for detailed information.
Regards.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery )
Consultant Neurosurgeon
Sunway Medical Centre
+603 74910777
fclee.neurosurg@gmail.com
Hi. I have a cousin who was diagnosed as having ataxia. She is now immobile. She can move her arms, legs, fingers and toes but she cant stand, walk or use her hands to feed herself. Is there any hope for cure? She is 57 years old and has been immobile last 3 years. She is not on any medication. Pls advice what can be done. Thanks.
Dear Noriza
Our apologies for the delayed reply – your comment was caught in the spam filter.
Treatment for ataxia depends on identifying the cause. There are many, including brain tumour, distant cancer, metabolic problems, degenerative conditions and inherited diseases. Do speak to your cousin’s doctors about her diagnosis and treatment plans. If the condition has no curative treatment, then physiotherapy for minimising deformity and home modifications for falls prevention are her only options.
Best wishes, Webmaster
Dear DR. LEE,
My father (65 years old gentleman with underlying Hpt) diagnosed to have large falx meningioma. Excision done on 10/2/2014.However, 3 hours postoperation developed intraventricular hematoma.urgent evacuation done and EVD inserted.The sad thing is now infection comes in.csf from EVD showed ESBL(Klebsiella peumoniae).currently on iv meropenum and iv vanco. Doctor,I beg for your help to save my father life (I am thinking of ventriculitis). Can I have a chance to meet you as soon as possible?
I am just a junior doctor, I am helpless now. My dad always give me the best,I hope I can give him the best too. Doctor Lee,please help us.Looking forward for your reply.
Sincerely,
Ng
Dear Dr Lee,
My 43 years old brother has been suffering with epilepsy since very young age. Though he has been on medication since then his condition has been deteriorating lately with more frequent seizures. I was told surgery may provide alternative treatment and it is now available in Malaysia. Please advice.
Dear Mr. Othman,
Epilepsy surgery indeed has been available in Malaysia for more than a decade. Adequate trial of medications is the first step in the optimal management of epilepsy. Intractable epilepsy or secondary epilepsy (e.g. underlying tumor) undergoes surgery after elaborate pre operative workout.
Do see experienced neurologist for epilepsy control – contacts on our website, as well as the National Specialist Register http://www.nsr.org.my/list1view.asp?page=1.
Thank you.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Hi doctor,
Can you advise how much does lipoma surgery cost? My dad got one about 4-5cm at back neck and it causes pain sometimes. Thanks a lot.
Dear Joyce
Please contact Dr Lee’s clinic for discussion (details on “Contacts” page).
Best wishes.
What are your thoughts on the use of cyberknife to treat a carotid body tumor instead of surgery which poses a lot of risks.
Dear Amy,
Cyberknife radiosurgery has been used to treat Carotid body tumors and achieved arrest of tumour growth successfully with / without adjunct surgical debulking of the tumour pre or post Cyberknife.
Thank you.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Happy new year Dr. Lee. You operated on my daughter when she was only 3 months old with the prognosis of shaken baby syndrome where her head swell and compressed the brain. When she was admitted, she was already in a coma and you quoted the probabilities of the surgery to be 50/50 and if she survived, she will be vegetable and/or paralyze.
12 years later, I am happy to report that the surgery is a BIG success…Not only you save her life, she now live a normal life and being the best student in her school. My family and I can’t thank you enough for your bravery and skills in attending to our daughter. Her ambition today is to be a neurosurgeon like her hero. Again from us, THANK YOU SO MUCH….
On another note, our neighbour daughter (about 9 years old) is infected with Meningitis. The early symptoms was in October 2013 displaying high fever and immobility of the limb. When brought to the hospital, the doctor did not suspect meningitis. However, her symptoms became worse and in December 2013, SJMC detected meningitis after taking the fluid from the spinal.
After knowing about it and seeing our neighbour’s daughter today, my thought were back to my daughter 12 years ago and wish to help her the best I can,. My questions is there a cure for meningitis in Malaysia? And may I refer her to you for diagnosis and treatment?
Thank you again, Rozaidin.
Dear Mr. Rozaidin
Glad to know that your daughter is doing well.
Meningitis is treatable but may leave the patient with long term complication like effect on cognitive function and epilepsy. Hydrocephalus may benefit from shunt operation.
Thank you.
Dr. FC Lee
Consultant Neurosurgeon
Sunway Medical Centre
Hi, I have harrmohagic stroke on my right brain, been looking for and considering stem cell theraphy. Please notify me(010-231 2001) as how I can move forward from here. Thank you
Dear Calvern
Stem cells are now under intensive research, and beneficial results are being awaited. As such, stem cell therapy is not yet approved for routine clinical treatment.
Best wishes,
Webmaster
On behalf of Dr Lee
Dear Dr Lee,
What is ‘Failed Back Syndrome’? Can ‘pain’ being used as a indicator for someone to be classified under ‘Total Permanent disability’ category?
Appreciate your comment.
Thanks Doctor
Dear Raj
“Failed back syndrome” requires detailed assessment for confirmation. Your question is best answered by the doctor who is assessing the disability claim.
Best wishes.
Webmaster
on behalf of Dr Lee
Dear Dr.
My broth a 17 year old boy underwent a brain tumor removal operation a month ago .he had fosa tumor and it was near the medula. He is currently having a csf liquid accumulated in his brain. The doctors are suggesting a permanent shunt placement.is this the onliest option doctor. What are the consequences of this permanent shunt?
Dear Bhavani,
Permanent CSF shunt is needed in situations where there is obstruction to CSF flow to its final absorption at the vertex of the brain, in this case due to residual tumor in the posterior fossa.
It is a simple operation but demand for sterility is very strict as it involves the placement of a foreign body (shunt catheters) in the brain and abdominal cavity.
Good placement of the ventricular catheter at the frontal horn and peritoneal catheter in the peritoneal cavity will prevent the shunt from being blocked, thereby avoiding need for repeat operation for shunt revision.
Thank you.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Dear Dr.Foo. My brother had few rounds of shunt blockage.can i bring his report for further consultation as i dont really understand your terms below.
Appreciate your urgent revert as currently my bros permanent shunt removed due to infection and replaced wt evd for time being.thanks.
Dear Bhavani
Ref. your enquiry, please contact Dr Lee’s office at address on this website.
Best wishes, Webmaster
Hi, Dr. Lee, please help me. I am Clement Lee aged 47 about 80kgs, having a pain on the right buttock for about a year plus, after I had a fall on the factory toilet resulted from the slippery floor (the right buttock hit exactly on the floor). I can feel the pain that is deep inside the buttock muscle, and the position is right in the middle of the buttock muscle. However, there is no pain when pressing the buttock muscle.
I cannot stand too long (not more than 5 min), walk too fast or jogging or the pain starts. But when I walk around slowly, climbing the stair or sitting and squatting, there is no pain. I cannot carry heavy stuff, or the pain will come severe at night time. There is some minor numbness on my toes at the start, but it has gone off after a while.
I cannot lie with face down as the pain is severe. The pain is lesser when I lie on the right side as compared to that of the left side. I have to find a comfortable position that lessens the pain to get into sleep, which is crossing my right leg on the left leg. I have to get up several times at night due to the pain and to readjust the position before I can continue the sleep. This has been seriously affecting me on my office duties.
I was first diagnosed by an orthopedic. The MRI scan revealed a mild posterocental disc protrusion at L4/5 and L5/S1with disc desiccation and posterior annular torn but the nerve was not compressed. Also, there was a mild L4/5 ligamentum hypertrophy with mild central spinal canal stenosis noted (AP diameter about 9mm) and there was no slip disc. The doctor claimed that there was due to age degeneration. I was then referred to physiotherapy but it did not really help. The doctor was then suggested injection of steroid at the spinal, which might not 100% guarantee cure and I refused. (BTW, a blood test for the cancer was carried out but revealed nothing).
I went to a Chinese acupuncture, who claimed it was piriformis. The treatment of the acupuncture was really hurt and buttock pain has become worsen, as the result, I stopped the acupuncture.
Thereafter I consulted another orthopedic, who claimed that degeneration of spine was common and was not the cause of the pain. He suspected it could be due to a tear on the ligament at the pelvis. An x-ray was taken at the pelvis area but nothing revealed. The doctor prescribed some medicines (to strengthen the nerve) but were not working for me either.
Just about 4 months back, I decided to go for a sport doctor, who also agreed that the cause of the pain was not due to the degeneration of the spine but suspect the ligament tear. He asked me to seek physiotherapy for acetabular labral tear and I did but it did not really cure.
The doctor then suggested another MRI at the buttock area. The report of the MRI suggested that it might be a tear at the anterosuperior aspect of labrum, and the rest were normal. However, the doctor claimed that it was not the cause of the pain that I described, and then he suspect it could be due to Gluteus Medius muscle. Again he suggested another physio on Gluteus Medius strain, which I decided not to proceed, as I had no confident that he knew what was happening, and he was adopting trial and error approach.
Now I am back to square one. After spending so much of money, I still not sure what is the root cause of the pain, and don’t even talk about the treatment. What do you advise?
Dear Clement,
From the info provided, you seem to have a complex situation for which clinical assessment is needed. You may wish to ask your doctor for further guidance or otherwise, you could consider getting a second opinion.
Best wishes,
Webmaster
Dear Sir,
Thanks for taking time to run through my message. Appreciated your comments. Will seek for another opinion.
Hi Dr. Lee, my doctor suspects I have a tethered spinal cord when I mentioned my urinary and fecal incontinence. I really would like to see somebody who can give me an accurate diagnosis and sound advice on what’s going on. Would you be able to help me? Thanks a lot, Joe.
Dear Mr. Lim,
Tethered cord syndrome is usually present in association with spinal bifida, which in its occult form has only a small dimple, sinus or subcutaneous lipoma and hence not easily noticeable by untrained eyes. The symptoms you describe may well be due to tethered cord. MRI thoracolumbar spine and brain is needed, the latter to exclude associated brain anomaly. Urological assessment is essential before deciding upon definitive neurosurgery treatment to section the tethered filum terminale.
Thank You.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
MBBS, FRACS (Neurosurgery)
Sunway Medical Centre +6 03-74910777
ANOC
Advanced Neuroscience and Orthopaedic Centre +60 3 2282 6113
Dear Dr.Lee,
My mom is diagnosed with Motor Neurone Disease (MND) and she is now in her first year. It first started as her right thumb slowly loses strength, continues to deteriorate till now both her arms are weak, having difficulty to hold even a spoon. The back of her palms were seen shrinked over time, and also slurred speech.
Alternatives from other doctors were Rilutek (where we found out numerous side effects on online medical site), which only manage to slow down the progression of MND. Henceforth my mum decided not to try it as her other organs are still functioning well. Is there any alternatives you can suggest to her sickness? Your efforts are truly appreciated and my family and I would be deeply thankful for your kind attention, Dr.Lee. Hope to hear from you soon.
Dear Charmaine,
I am sorry to hear that your Mum is suffering from Motor Neurone Disease. This is a progressive degenerative disease of the brain with hitherto no definitive remedy. Rilutek as you rightly pointed out has costly sides effects and only slows down the decline.
Stem cells treatment shows promising prospect but at present the technology is not ready for large scale use. It is still categorized in most countries including Malaysia, as clinical experimental treatment. Using autologous stem cells cultured from patients own bone marrow cells is safe but its efficacy is unproven on clinical studies though animal studies appeared convincing.
I hope these informations are helpful to you.
Thank You.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre/ ANOC
Acvanced Neurosciencs and Orthopaedic Centre 03-74910777 or
+60 3 2282 6113
Thank you so much Dr.Lee! Appreciate your effort in replying amidst your busy daily schedule.
Hi Dr Lee,
I am Indonesian female, 28 years old. I got back pain, shoulder pain, wrist and my ankle also pain. It has happened since several years ago. I went to doctor in Indonesia few years ago then doctor only suggested me to do exercise like fitness and swimming. I did the x-ray scan. Unfortunately I forgot his diagnostic but I remember he said I got problem with my back bone. I follow his suggestion to do fitness and become better. Around 2 years ago, I stopped my fitness exercise and my pain become worst. I must face this every day and disturb my productivity. My job is IT consultant and required to do overtime almost every day. Please advise me what I have to do? Thanks.
Dear Miss Grace,
We will need to see the MRI and X-rays and other relevant blood test results to correlate with your clinical signs and symptoms before advising you on you condition.
You can make an appointment to see me at Lot 2.02,(East Wing), 2nd flr,menara BRBD,285,Jln Maarof,Bkt Bandaraya,Bangsar. (behind bangsar shopping center)
59000 KL
Malaysia +60 3 2282 6113 or
Sunway Medical Centre
5 Jln Lagoon Selatan
Bandar Sunway
47500 Selangor
Malaysia +60 3 7491 0777
Thank you.
Dr Lee Foo Chiang
Consultant Neurosurgeon
Dear Dr Lee
我们很衷心感谢您帮我们的两岁女儿Yu Tung在去年做了一个很好的手术(lipomeningocele)，使她有个美好和正常的生活。
感谢您的真诚对待。
愿您和家人2014年新年快乐，万事如意。
万份感谢
Dear Mrs Leong.
Thank you very much for your kind note. Happy New Year to you and your family too.
Dr. FC Lee
hi DR lee, i ave headache at the top center of brain, for 5 years, ihv do ct scan before but doctor say nothing, but it keep pain when i concentrate to do thing.. so iwould like if ct scan scan no problem, will MRi detect the problem? if the brain nerve is flammation but the brain size is normal,can it detect on ct scan? Mr Hong..
Dear Mr Hong
You need a comprehensive assessment to determine the cause of headache. This includes a thorough clinical and psychological assessment together with other tests as indicated. Besides problems in the brain, headache may be due to illness in other systems in the body, as well as mental stress. The scan may or may not provide the precise diagnosis. You are advised to consult your doctor for the next steps.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Dear Dr Lee,
My husband, 37 years old (living in Jakarta, Indonesia) was a post stroke patient. He was diagnosed to have a brain stem blood clot and treated at the hospital for one month. At the time of stroke happening, he couldn’t swallow anything (even his own saliva) and couldn’t move his left part of his body. After discharged from hospital he was consistently done all of therapies (physiotherapy, speech therapy) and all of tests that he has to do. His physical recovered quite quickly, he can walk and do many things again just like before, right after 1.5 months being discharged from hospital. The problem is up until now he still cant eat and drink orally (it’s been 10 months already), he has been using PEG to supply the food and drinks to his body.
He started to get frustrated due to not being able to eat and drink orally for 10 months.
Could you please kindly advise or suggest what kind of actions that he could do to cure his illness?.
Thank you and looking forward to receiving the reply from you soon.
Dear Yanti
Review of your husband’s treatment indicates that he has received all the necessary up-to-date treatment for his condition, and he appears to be responding to rehabilitation.
Hopefully there will be further improvement with time.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Dear Dr. Lee,
Good day! My mother-in-law had taken MRI diagnosis of her whole spine last week and the impression stated as following:
1）T5-L1 paravertebral mass with bones infiltration and encasing the right T6, T7, T8, T9 and T10 exiting nerves suspicious of malignancy.
2) Mild C3/C4, C4/C5 and L4/L5 PIDs.
3) C5/C6 PID indenting the spinal cord and mildly narrowing the spinal canal.
I would like to ask advises from Dr. Lee about the conditions stated above.
Please also recommend which specialist should we refer to?
Please arrange us have a meet at ANOC as soon as possible.
Please advise. Thank you！
Regards,
Connie
Dear Connie
Please see your email for a personal reply.
Best wishes, Webmaster
Hi Dr Lee, my mom 57 years old who is diabetic for 17 years. Recently she felt numbness on her left hand especially when she raise the newspapers while she lying on bed. Kindly advice.
Dear M Wong
Your mother needs a clinical assessment and perhaps some appropriate tests for diagnosis, before any advice can be formulated. She could consult her GP for the next steps.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang
Dear Dr Lee,
My son 6 years old which diagnosed brain tumor call pontine glioma measure 3.4×4.6×3.4cm on feb 2013 and can,t do surgery on that part. Already done radiotherapy and chemotherapy at Singapore. Overall seem looking good n the tumor shrink small. Unfortunately in this sep, his right eye suddenly kept to the left side, another one is normal. MRI show that the tumor is become larger and slightly enhancing area at the right side. Singapore Dr is no more solution. So I’m here to seeking for your help, please…
I’m already check with your clinic but you are in full appointment at sunway. Bangsar only first come first serve, can’t make an appointment. Do you have another way which we can meet as soon as possible? Because my son situation now is getting worst, cannot walk properly, will fall down.
Please Dr… Thank you very much.
Dear Mrs Yeoh
We are sorry to hear of your serious concerns. Please see your email for a personal response.
Best wishes,
Webmaster
Dear Dr
my dad(59years old) was diagnosed with brain tumor on 28/11/2013.according to my ENT DR,the size is 4cmx1.9cmx2.5cm T2W increased signal intensity mass lesion at right CP angle and IAM region.Dr informed that it is 70% operation successful rate & permanent side effect(dizziness,loss of hearing,facial expression disorder).can we seek for second opinion or should we undergo surgery?
Dear Jo
Feel free to come for second opinion.
Thank you.
Dr. F C Lee
Consultant Neurosurgeon
Sunway Medical Centre
03-74910777
Dear Dr Lee,
I am from Penang. My dad is suffering Trigeminal Neuralgia and currently is taking Carbamazepine, but the medicine seem like does not help much…pain remain. I heard about a surgery call “micro vascular decompression” can leads to permanent cure of Trigeminal Neuralgia and you are the doctor recommend to us. We would like to ask how much would be the cost to do the surgery in Sunway?
Thanks.
Dear Miss Kelly,
Thank you for your e-mail.
Micro vascular decompression surgery for trigeminal neuralgia is a successful and safe surgery for pain which is not controllable in spite of adequate doses of medications.
Please see your email for a personal reply.
Kind Regards.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Senior Consultant Neurosurgeon
Dear Dr Lee,
Can you tell me how much does the cost of the surgery (MVD)? My mother is suffering Trigeminal Neuralgia and we are from Indonesia.
Dear Uli
Please see your email for a personal response.
Best regards.
Dear Dr. Lee,
My mum has a suspected herniated disc in her neck as she is experiencing numbness and tingling in the right arm. What kind of treatment is recommended and is an MRI scan required?
We would like to find out if you have a clinic we could visit on Sat. Do you recommend coming to see you soon if my mum has been experiencing this numbness for about a month now? Should she see a chiropractor, neurologist or neurosurgeon on this? Thank you.
Dear Miss Anna,
Surgery for the relief of herniated cervical disc with nerve root compression can be performed by neurosurgeons under operating microscope with high degree of success rate and minimal risk.
Surgery takes 1 1/2 hours and relief is often immediate. Patients are allowed to walk the next morning and go home the day after.
Feel free to contact my office at Sunway Medical Centre 03-74910777 or 03-74919191 ext 15519. Clinic days Tuesday 2-5pm Thursday 0900am-300pm.
I also see patients on Wed and Fri 2-5pm at ANOC
Advanced Neurosciencs and Orthopaedic Centre Lot 2.02 (East Wing), 2nd Flr, Menara BRBD, 285,Jln Maarof, Bkt Bandaraya,Bangsar. (behind bangsar shopping center)
59000 KL
Malaysia +60 3 2282 6113
Thank you
Dr. Lee Foo Chiang
MBBS, FRACS ( Neurosurgery)
Consultant Neurosurgeon
Hi Dr. Lee, my brother had an accident around 10 years ago, leaving him with pinched nerves in his back. He had never really gone for any treatment until recently when he started feeling painful sometimes as he walks. He had tried a few massage treatment but it hasn’t seemed to have improved yet. One of the consultants in Indonesia suggested him to do a surgery, but the chance is 50-50 for him to survive the surgery without becoming handicapped. Is there anyway he can recover and is the chance really 50-50?
Thank you.
Dear Serlie Fatrin,
Thank you for your enquiry.
Surgery for the relief of a pinched nerve in the back, which I presume is in the low back, is a very common microsurgical operation by neurosurgeons with a high success rate. The same can be said for the cervical or thoracic spine.
I hope you find this information helpful.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
+603-74910777 +603-74919191 ext 15519
fclee.neurosurg@gmail.com
Dear Dr. Lee,
My mum has a suspected herniated disc in her neck as she is experiencing numbness and tingling in the right arm. What kind of treatment is recommended and is an MRI scan required?
We would like to find out if you have a clinic we could visit on Sat. Do you recommend coming to see you soon if my mum has been experiencing this numbness for about a month now? Should she see a chiropractor, neurologist or neurosurgeon on this? Thank you.
Hi Dr Lee
My dad has a pituitary gland tumour of 4.4cm.
We would like to ask how much would be the cost to do the surgery in Sunway?
Does she need any radiotherapy afterward? If yes, how long and how much would it cost?
Thanks a lot
Eunice
Dear Eunice
Thank you for your enquiry. Please refer to your email for a personal response.
Best regards, Webmaster.
Dear Dr. Lee,
I don’t know what to do now for my mum who was suffer from Degos disease. Can you suggest any medication or treatment for this disease ?
Regards,
May Ng
Dear May
Degos syndrome is a complex disorder for which treatment needs to be tailored to the individual patient. Please consult your mother’s specialists for advice. For information, treatment is generally medical rather than surgical.
Best wishes.
Webmaster
on behalf of
Dr Lee Foo Chiang, Consultant Neurosurgeon
hi Dr Lee,
My brother underwent craniotomy due to burst in the blood vessel in mid of jan this year. It affected his memory, he is 45 years old. After six month of the operation, he had his first epilepsy in july. The doctor said it was the side effect of the craniotomy. How to cure for his epilepsy ? Is epilepsy due to craniotomy curable ? Does he needs to go for MRI again ? Which doctor should I send him to ?
Can you advise me what to do ?
Thank you very much !
Dear Amy,
Your brother’s epilepsy can be attributable to the effect of brain hemorrhage leading to scarring in the brains or any surgery on the brain substance.
Neurosurgeons or neurologists usually can help to control the epilepsy with one or more of the many antileptic medications. Surgery for epilepsy is a last option.
Thank you.
Dr. Lee Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre/ Beacon International Specialist Centre/ ANOC
Hi Dr,
I would like to check my daughter was initially scanned n diagnosed as holoprosencephaly alobar..mri and ct scan done… now the doctor who’s treating her says she needs a shunt.. what is exactly her illness can be?! N is this shunt is really needed as she is 6days old n her head size remain 38.5… and what is the cost at sunway medical for a shunt procedure roughly?! Pls advice
Dear Dev,
A shunt is not a major neurosurgical procedure even in the very young, though the requirement for sterility is very stringent. A low profile shunt is generally used in babies or young children. Programmable VP shunts are available to allow for shunt pressure adjustments in the clinic to fine tune the drainage rate of CSF.
VP shunt procedure costs RM 10-15K and if programmable shunt is chosen the cost may go up by another RM 5-6K due to the price differential between the standard and programmable shunt.
Thank you.
Dr Lee Foo Chiang
Consultant Neurosurgeon
A good day Dr Lee,
I hope i could get the good advice from you Dr, this is my humble request.
My father now 56 years old, had gone surgery in 2004 due to left temporal lobe glioma grade 2 and was done with radiotheraphy too in one of the specialist hospital.
Right now my father had slurring of speech and have weakness on his right hand and the leg.But sometimes his speech do progress well and there are times it slurred. He stumble whenever he walks. Plus he also have one side hearing loss especially on his left side.
The neurosurgeon found from the recent mri that there is an evidence recurrence on the same place and it is surrounded with the odema as well. The tumour is right beside the stroke part of the brain. That is only my understanding as a layman.
They have suggested to go for Cyberknife because a resection can cause paralyse on his right side of his body but my concern is do this treatment will cause much complications as opposed to resection and is there any chances of having brain swelling after the treatment.
The second question even after the cyberknife treatment is there any ways that my father can get back to his normal life as he was earlier.
I have provide you the MRI link for your reference purpose
https://docs.google.com/file/d/0By5vhmStY8F0LVlnNHloU0sxZk0/edit?usp=sharing.
I really hope to get a better advice so i can proceed for further treatment.Would appreciate for your help Dr.
Dear Mr. Kishan,
There are a few options for consideration. Low grade glioma tends not to be radio-sensitive. If the recurrence occurs in a dispensable part of the brain, further resection is the choice. On an evocative part of the brain, however, the neurosurgeon may want to consider awake brain mapping during surgery to minimize the disability resulting from resection of the tumour. Further more low grade glioma may increase in tumour grade to a higher WHO grade. This can only be confirmed at time of surgery. Do consult your neurosurgeon on further treatment plans.
Regards.
Dr. FC Lee
Dear Dr Lee
Do you treat infant of 16 months old suffer from hydrocephalus ?
Best regards
See loong
Dear Mr See Long,
Hydrocephalus is a common neurosurgical condition for which there are established treatments.
Yes, I treat hydrocephalus.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Hi Dr. Lee,
My mum suffer from back pain few years ago but now it’s getting worse. She can’t walk properly because of the back pain. What kind of treatment required for her case? She took some supplement for backache but it doesn’t really cure the pain. Thanks in advance.
Dear Adeline,
You may want to bring your mother to see a neurosurgeon for a neurological assessment followed by MRI scan of the lumbar spine.
If the examination and scan confirm presence of a prolapsed lumbar disc. spinal neural foraminal narrowing or instability of the lumbar spine (spondylolisthesis) she may benefit from surgery which can take the form of Microlumbar discectomy neural foraminotomy and spinal fixation respectively.
Thank you.
Dr. Lee Foo Chiang.
Consultant Neurosurgeon.
Sunway Medical Centre (03-74910777, 03-74919191-15519)
Advanced Neuroscience and Orthopaedic Centre ANOC
Lot 2.02 (East Wing), 2nd Flr, Menara BRBD, 285, Jln Maarof,Bkt Bandaraya,Bangsar. (behind bangsar shopping center)
59000 KL
Dr Lee,
Please help to advise. My aunt had a stroke and docs have done mri, TEE and results came in negative. She has been in the hospital for more than 2 weeks aand doctors are stumped as to what is causing the stroke. Her speech is slurry and her right side is numd and her left aarm is weak. Her right eye needs to be closed and she is having double vision. She vomits a lot.
Doctor did another mri yesterday and found that my aunt has a tumour on her brain stem. A biopsy is scheduled this Friday. Is this a wise thing to do? Please advise as to what is the next course of action to save my aunt. Please do reply as soon as you can. I can have the medical reports ready for you to see to make a sound advice. I am afraid if time is running out so please do contact me as soon as you can.
Dear Elina,
Stroke with the presence of cranial nerves deficits in clinical medicine always point towards brain stem pathology, in your aunt’s case, a brain stem tumour. It sounds like an intrinsic tumor arising from within the brain stem. Conversely an extrinsic tumour can also give rise to similar symptoms if it is large or located in strategic regions of the brain stem.
It is of course good to know the nature of the tumor. This is done through a so called biopsy either done through stereotactic method or open biopsy. Usually resection (partial) is done at the same sitting to relief pressure on the brain stem.
The remnants of the tumour can usually be treated with radiosurgery and Temodale if the tumour turns out to be a glioma.
I hope these informations can be of help to your aunt and family as the consider the treatment options.
Thank you.
Regards.
Dr. Lee Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre.
03-74910777, 03-74919191 ext 15519
fclee.neurosurg@gmail.com
Dear Miss Elina,
It is difficult without looking at the MRI brain scans and preferably the patient herself to be able to advise you properly. MRI usually gives a reliable idea of the nature of the tumor. You are welcomed to bring the MRI scans to my clinic at Sunway Medical Center or ANOC.
Thank you.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Hi Dr Lee,
my cousin, 17 yrs old is having hearing problem. his mom brought him to check his ear, but the results is still same. recently his hearing becomes weak, we worry that it could be his brain nerve problem.
hi doctor, i would like to seer advice n which department i should bring my cousin to go to? should i bring him to check his hearing 1st, get the report and then check his brain nerve?
Dear Anna
Hearing problem should first be assessed by Specialist in Ear, Nose and Throat Diseases. You are therefore advised to consult the ENT Consultant.
Best wishes.
Webmaster
on behalf of Dr Lee Foo Chiang.
Dear Anna,
Thanks for your enquiry.
You may want to bring him to have a thorough examination by an ENT surgeon as a first step, if that has not been done. A good hearing test by an audiologist is essential. Secondary hearing loss can be caused by neurological causes and would require him to be seen by a neurologist or neurosurgeon. An MRI brain scan is necessary to rule out mass lesions like tumours.
Thank you.
Dr. LEE Foo Chiang
Consultant Neurosurgeon.
Sunway Medical Centre/ ANOC Advanced Neuroscience and Orthopedic Centre.
Dr, PLS HELP MY DAD !!! My dad is diagnosed with PSP, movement disorder. My dad is a very strong willed person. Even kpj damansara doctors acknowledged tht my dad made an amazing recovery from 2 times cpr arrest. Two days ago, my dad has been transferred to university hospital, after more than a month at kpj icu. However, after eeg n relevant scans, they said tht my dad’s brain is not reacting much to their test. But dr, i hav all videos showing tht my dad indeed responded to us with the witness of nurses. Not reflex. I wish to speak to u dr. Pls help my dad. My no is 0122784242.
Dear Teri
It is not possible to provide advice based on the information given, without the benefit of a clinical assessment. Do please refer to your father’s doctors for updates on his condition.
Best wishes.
Webmaster
On behalf of Dr Lee Foo Chiang
Dr Lee Foo Chiang I want to ask what my son disease . I wan to buy a policies insurance for him.
My son named Tan Wei Jean yr 2008 treated by you at sunway. He now age 16. Can dr lee give me details of the diagnosis &. Treatment surgery.
Dear Sir/Madam,
Reference your enquiry, you are advised to call my office at Sunway Medical Centre during office hours and request my staffs to retrieve your son’s medical file.
The proper procedure will be to have your insurance agent bring the “attending physician statement” form to my office to be filled up by me. This may take more than two weeks.
Thank you.
Dr. LEE Foo Chiang
Dr.Lee,
i slipped and passed out last week,.done 2ctscan and eeg test, discharged after two days. after 7 days, i still feel a little giddy, and my movement are limited else i feel light head. feel a little numbness on my head when i bend down. is this normal, how long before i can fully recover.
Dear M Cheah,
It is not possible to provide advice based on the information given, without the benefit of a clinical assessment. Do consult your doctor about your concerns.
Best wishes for recovery.
Webmaster
On behalf of Dr Lee Foo Chiang
Dear Dr. Lee,
My mom (65 yo, currently living in Indonesia) recently has a sudden swelling yet no acute pain on her right shoulder joint since July 18th 2013. Previously, she had been generally in good health and had previously been very active. Now she becomes very afraid that she will further damage the shoulder if she uses her right hand as she can hear a loud creeping sound when she moves her arms to certain directions. The unstable swelling and creeping sound had been really annoying her.
She has consulted some Orthopedics in Jakarta and has gone through the following examinations:
1. Physical
>>There is a creeping sound when she rotates her shoulder backward and forward, upward and downward. And she feels light numbness on her triceps area thru the bellow elbow area.
2. X-Ray (shoulder dextra, bilateral and manus).
>> It was found deformity on the corpus of the humeral bone
3. Total Blood Count check
>> The CRP was found to be a bit high
4. Ureum and Creatinin
>> The reading was normal
5. MRI
6. CT-Scan
7. Bacteria culture from the fluid aspirated from the shoulder joint.
>>It was found acinetobacter baumannii.
Medication taken for the first week was Non-Steroid Anti Inflammation Drugs. Prescribed by orthopedic in Jakarta that she consulted, she has taken Co-Amoxiclav 500mg, three times a day since Thursday August 1st until Sunday August 18th.
We also have gone for second opinion examination to orthopedic in Singapore last Lebaran holiday, and his diagnosis was my mother had neurophatic shoulder due to syringomyelia (based on the MRI results).
I would like to bring my mon for further consultation to a neuro-surgeon for second opinion. What is your diagnosis for her shoulder? We hope you can provide examination and more information (diagnosis and treatment plan) on her case. Please inform, doctor. Please advise if we are able to see and consult you – or if not, can you please assist us by referring which doctor that we shall consult to for this case, as we hope to give the best treatment for her.
I can be contacted at my email fennychudri@yahoo.com or by phone at +62 8128620700. I am looking forward to hearing from you soonest. Thank you. Fenny Chudri
Dear Fenny,
Thanks for your e-mail.
It seems quite certain that your mother has septic arthritis of her shoulder joint based on the fluid culture result of acinetobacter and X-ray findings. If she has syringomyelia on MRI of the cervical spine then it may explain why she has minimal pain despite the joint swelling from joint infection.
I think the more urgent issue is to have the septic arthritis treated adequately with antibiotics first. Syringomyelia can be managed with syringostomy and Gardner’s operation (decompression of craniovertebral junction) at a later stage. This will have to be done by neurosurgeons.
Regards.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Sunway Medical Centre, Selangor, Malaysia
+603-74910777 +603-74919191ext 15519
fclee.neurosurg@gmail.com)
ANOC
Acvanced Neurosciencs and Orthopaedic Centre
Lot 2.02,(East Wing), 2nd flr, Menara BRBD,285, Jalan Maarof, Bukit Bandaraya, Bangsar. (behind Bangsar Shopping Center)
59000 KL
Malaysia +60 3 2282 6027
Dear Dr. Lee,
I am Ingrid from Indonesia, 37 yo. I have been having back pain for the last 2 years and recently it’s getting worse. I fell about 2 years ago and had MRI. There was abnormality, but not really extreme. My doctors suggested either surgery or therapy. I chose therapy.
Some part of my left leg to my foot has been numb since the accident and it hasn’t gone away. Since it isn’t really disturbing, I learned to live with it. However, my back pain is getting worse and it’s getting unbearable. If I would like to schedule a consult, what should I do first? Thank you.
Dear Ingrid,
Thanks for your e-mail.
I think there is most probably a prolapse disc causing compression of a lumbar-sacral nerve foot. It may benefit from a Microlumbar discectomy which is a minimally invasive surgery usually with good relief of your symptoms. Surgery usually takes 40 minutes and you may be allowed to walk the next morning and be discharged from the hospital in another day or two.
Thank you.
Dr. LEE Foo Chiang
MBBS, FRACS (neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
603-74910777
fclee.neurosurg@gmail.com
Hi Dr Lee,
My mum is a 80 year old lady with 10 children and 25 grand children. She has been taking the usual medicines for elders since 10 year ago. But her memory power has showed a sharp deterioration lately and tends to misplaced her own things frequently. We are concern that things may get worst and we wish to seek your opinion on what we can and should do to help her with her memory and prevent things from worsening.
Thanks and regards.
Dear Mr Tan,
I think the best specialist for your mother’s problem would be either a neurologist or a geriatrician.
Best wishes.
Dr. Lee Foo Chiang.
Dear Doctor Foo,
My husband suffered very serious migraine since teen, he is 39 yrs old now, for this few weeks his migraine seem getting worse, he took at least 6-8 pain killer and still cannot get over the pain. What should I do? Should he see you or nerogist? Please advise.
Warmest regards,
Lynn Tay
Dear Lynn
There are a number of medications for severe migraine. For proper treatment, do ask your husband to consult a neurologist, who may decide whether the diagnosis is appropriate, and whether tests are needed.
Best wishes.
Webmaster
On behalf of Dr Lee Foo Chiang.
Hi Dr Lee
My mom has a pituitary gland tumour.
She had it removed 6 years ago. She did not do any radiotherapy at that time.
Now it has been regrow.
We would like to ask how much would be the cost to do the surgery in Malaysia?
Does she need any radiotherapy afterward? If yes, how long and how much would it cost?
Thanks a lot
Effendi
Dear Henny,
Thank you for your e-mail.
I think the recurrent pituitary tumor can be removed through the nostril ( transphenoidal surgery) with the incision on the gum, by neurosurgeons without having to go through the brain ( craniotomy).
This is a very safe and straightforward operation and takes about one and half hours.
If Radiotherapy is indicated it is better to opt for stereotactic fractionated radiosurgery with Cyberknife.
Please see your email for more details.
Thank you.
Regards.
Dr LEE Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre
603-74910777 603-74919191 ext 15519
fclee.neurosurg@gmail.com
Dear Dr Lee,
i had my operation of l4/ l5 disc op 2008 and l5 /s1 disc op 2011 at melaka pantai hospital.
last week, i had severe numbness of right leg.
i did MRI last week and found out that the disc protrusion at l4/ l5 and l5/ s1 levels.
i am lacking confidence to the doctor who help me to do the past 2 operation.
i was told to find neurosurgeon rather than orthopedic doctors.
the report from the MRI stated as below:
FOCAL DISC PROTRUSION at l4/ l5 and l5/ s1 levels.; PREVIOUS LAMINECTOMIES AT BOTH THESE LEVELS NOTED.
THE L4/ L5 LEVELS FOCAL DISC PROTRUSION IS LARGER SINCE PREVIOUS SCAN, AND NOW CAUSES MORE SIGNIFICANT NARROWING OF THE SUBARTICULAR ZONES, AND COMPRESSION OF THE L5 NERVE ROOTS(WORSE ON THE LEFT).
RESULTANTS MODERATE SPINAL CANAL STENOSIS AND MILD BILATERAL NEURAL FORAMINA NARROWING AT THIS LEVEL NOTED.
THE L5 S1 LEVEL FOCAL DISC PROTRUSION HOWEVER IS SMALLER SINCE PREVIOUS SCAN. IT IS MODERATELY NARROWS THE RIGHT SUBARTICULAR ZONE, BUT IT IS COMPRESSIVE EFFECT ON THE RIGHT S1 NERVE ROOT LOCATED THERE HAS IMPROVED, ALSO IN THE PART DUE TO THE INTERVAL RIGHT LAMINECTOMY.
MODERATE RIGHT NERVE FORAMEN NARROWING IS STILL NOTED.
THE REST OF THE LUMBAR SPINE IS UNREMARKEABLE.
Dr. Lee, I would like to seek for your advise, what is the next step I should do to solve my numbness and pain of my leg.
Thank you.
Best Regards
jerry
Dear Mr. Lim,
It appears there is a recurrence of disc herniation.
Repeat discectomy is indicated if conservative treatment has failed.
Micro lumbar discectomy is usually done by neurosurgeon as a first option in cases not previously operated.
Repeat discectomy is more demanding technically due to previous surgical scarring. Operating microscope magnification certainly helps.
I hope you find these info useful.
Thank you.
Regards.
Dr. Lee Foo Chiang
Consultant neurosurgeon
Dear Dr. Lee
Thank you for your advise on 24 July 2013.
For your information, I have gone through the following check up:-
Year 1999 – CT Scan of Lumbar Intervertebral Disc L3 – S1 = no obvious PID seen at all levels. No osteophytosis. No evidence of spinal stenosis seen.
Year 2000 – Lumbosacral spine = mild scoliosis to the right? Significance (after fell down from the staircase).
Year 2004 – MRI Cervical Spine at Sunway Medical Centre, but no report, assume everything are fine ???
Year 2011 – MRI Cervical Spine at UM specialist Hospital = Image quality degraded by motion artifact.
The cervical alignment appears normal.
The Cervico – medullary junction is normal.
The Cord returns normal signed.
The exit foraminae are normal.
The Carotid vessels normal.
The R vertebral is smaller and appear to enter the foramen transversum at higher level.
At the same time, I have EMG report comments that : Nerve conduction studies and needle EMG are within normal limits.
Dr. Lee, I would like to seek for your advise, what is the next step I should do and which specialist should I refer to to solve and find my problem on the numbless of my hand and leg and with the pain of my neck and lower back bone pain?
Thank you.
Best Regards
Sally Tan
Dear Miss Tan,
I note you were not told of the MRI Cervical Spine 2004 which you presume were “normal” and the UMMC scan 2011 was of “degraded ” quality.
It may be worthwhile to have a re look of your clinical symptoms and signs as well as neuro imaging and neuro physiological tests.
You may see a senior neurologist like Dr Lee Moon Keen or neurosurgeon.
Hope you find a definitive answer and treatment to your problem.
Regards.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
e-mail: fclee.neurosurg@gmail.com
Sunway Medical Centre 03-74910777 ANOC
Advanced Neurosciencs and Orthopaedic Centre +60 3 2282 6027
Dear Dr Lee
I am 49 years old lady working in Penang. Recently diagnosed by doctor that I am having ependymoma within my cervical cord from C1-C6. MRI done and impression that I am having intramedulary mass with cystic component and hemorrhage. I am interested in radiosurgery than the laminectomy please advice more on the above. Thank you Dr Lee.
Dear Miss Chan,
Thank you for your e-mail.
Intra medullary tumors, the commonest being ependymomas and astrocytomas very often lends itself to micro neurosurgical resection under operating microscope and Intraoperative neuro physiological monitoring.
Very often there is a plane of cleavage between tumour and normal spinal cord tissue in appearance and consistency and color under operating microscope.
Also it is important to know the exact histological diagnosis of the tumour and especially the grading on tumour cell aggressiveness. This allows for prediction of the tumour behavior in the future.
Debulking the tumour reduces the tumour size facilitating further treatment.
Cervical laminotomy will be done with sonic scalpel to allow for replacement of the posterior component ( lamina) after tumour removal, therefore offering bony protection on the back of the spine.
Stereotactic radiosurgery if indicated, for intra medullary ependymomas or astrocytomas is best done with Cyberknife but carries with it the risk of radiation damage to the cord tissue with paralysis while radio responsiveness or these tumours to radiation is not definite nor encouraging.
Post radiation scarring around tumour will mask the boundary of the tumour making subsequent surgery more difficult.
You may contact my office for a more detailed assessment and discussion on the management.
I hope you find these informations helpful.
Regards.
Dr. LEE Foo Chiang
MBBS, FRACS (neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre (03-74910777)
ANOC Acvanced Neurosciencs and Orthopaedic Centre (+60 3 2282 6027)
fclee.neurosurg@gmail.com
Hi Dr. Lee
我妈妈的脚板生骨刺，适合见您吗？
Jane
Dear Miss Saw,
脚板生骨刺要看骨科医生。
谢谢。
Dr. FC Lee
Consultant Neurosurgeon
Sunway Medical Centre
Dear Dr. Foo
I am having problem of numbless on my hand for the past ten year, recently getting worse, it goes to my leg as well, normally the numbless would move around, sometime in right hand and sometime in left hand, and all the time I have lower back bone pain, I can’t side sleep for more than 10 minutes, and I noticed that when I have done any exercise which need to use strength on the neck and lower back, my numbless would increase and feel in immediately. However, for the past 10 years, i went to see manys doctors, it includes traditional chinese doctors, neurosurgeon, cardiologist and orthopaedic they all said nothing wrong to me. Neurosurgeon check on my reaction of my leg and said that is it abnormal and it could be “Spurs” problem. However, after the MRI out, it shows no “Spurs” problem on my neck and lower back bone, but I went to see two traitional chinese doctors, they all claims that I have spurs on my neck and lower back bone. So, Dr. Foo, could you please advise what is the actual problem of me? which doctor should I refer to the next? is it Spine Specialist, if yes, any recommendation for this spine specialist? Please help, as for the past few days, my leg’s numbless continuous none stop and make me feel very bad.
Thank you.
Regards
Sally Tan
Dear Miss Tan
To further elucidate the potential underlying cause for your symptoms, you may require MRI cervical, lumbar spines and nerve conduction studies apart from a thorough clinical neurological examination by either a neurologist or neurosurgeon.
We need to exclude compression of the spinal cord/ nerve roots by whatever causes as well as peripheral nerve disorders. Metabolic disorders can contribute to the latter.
Hope you find these informations helpful.
Regards.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre
Dear Dr. Lee,
I had MRI in 2000 in SMC and confirmed that Slip Disc at L4 & L5. This costs my Left Buttock pain when I stand more than 10 minutes and if I have slow walk.
Can Laser surgery in your clinic?
Dear Mr Wong,
The definitive treatment for prolapsed lumbar disc where there is intractable pain from nerve root compression despite conservative treatment including physiotherapy is micro lumbar discectomy / endoscopic discectomy. In selected suitable cases, per cutaneous disc nucleolysis can be done.
Best wishes,
Dr Lee Foo Chiang
MBBS, FRACS (neurosurgery)
Consultant Neurosurgeon
李医生，您好！
我母亲今年62岁，最近投诉左眼视力退化，看了眼科专科，但是医生说不视力不全是老化的问题。后来照了MRI，发现靠近PITUITARY附近长了大概1.8 mm的瘤，压了视力神经线。 请问是不是该动手术呢？手术费大概是多少？谢谢
Sim 小姐，请参阅您的电子邮件私有回复。谢谢。
Best wishes,
Webmaster
Dear Dr. Lee
I was referred here by Dr. Yong Kam Leng. I am a 50 year old diagnosed with chronic pain syndrome since February 2012. MRI of lumbar shows L5 S1 annular disc tear and C5/6 disc with endplate fracture, disc space narrowing and bone marrow infiltration as well as an annular tear at this level. MRI of neck shows small annual tear at C6/7 with a small disc bulge. There was no evidence of neural foraminal stenosis and nerve root compression at any level. Muscular skeletal doctor recommended pain management due to spinal cord sensitization responsible for the widespread pain. I was later prescribed gabapentin in August 2012 but pain level remained high at about 8/10.
This April, I saw a neurologist. He examined my nervous system and found it normal. He prescribed me with nortriptyline in addition to gabapentine I was still taking. After 2 months on nortriptyline, I was able to withdraw gabapentin. I am on 3.5 tablets of 25mg each at present. My pain level is now at 2-3/10. I do get tingling on my left arm and dull pain on both shoulders and muscle spasms in my right leg occasionally.
Based on the above, do you think continuing with this pain management is the best way to go. Are there other options available?
Thank you in advance for your time.
Best regards
Belinda
Dear Belinda,
Thanks for your e-mail.
Pain with no structural neural compression demonstrable on MRI (as reported by radiologist) is best handled by pain clinic team. However it is still worthwhile to let a neurosurgeon familiar with spinal neurosurgery correlate your clinical signs and symptoms with the “normal” MRI. It may lead to a more definitive treatment and long term relief of your pain.
Best wishes.
Dr Lee Foo Chiang
Consultant Neurosurgeon
Dear Dr. Lee
Thank you very much for your prompt reply.
Best regards
Belinda
Dear Dr Lee
My name is Debbie from Indonesia , i am 42 yo , i have suferring hfs since 2010 , my both side checks are always tics and now getting worst . maybe the surgery like mdv is the best treatment to cure my pain . Could you pls give me information how much for the expense for the surgery in your hospital ? Many thanks for your attention
Dear Miss Debbie,
Thank you for your email. Please see you email for a personal response.
Webmaster
Dear Doctor, I have a deep cavernoma in the L.parietal lobe, sensory area. symptoms right face numbness, weakness of leg. when i get micro bleed i get headaches, right palm burns for few days and pains/numbness until 1-2 weeks later i get much better, with minor symptoms again.
micro bleeds are caused by more then 10 min on exercise bike, or activity with my wife.
Do you think these are micro bleeds?
i had MRI for past 3 years period and the cavernoma has remained the same size 1cm, i theorize that the micro bleeds stops it from growing bigger 3cm, that is why i notice my friend who had a larger cavernoma has only slight symptoms compared to me. his grows, mine bleeds. his cavernoma was in the r.parietal lobe. removed and no more facial tics/numbness and confusion. he also stopped seizure meds.
Do you recommend removing a deep cavernoma? and do you think a devide like the nico myriad neuro tool will help?
thanks
peng
Dear Peng,
We will need to see the MRI and perhaps do further tests like functional MRI/DTI to study the relationship of the speech and motor function before deciding whether it is worthwhile to resect the cavernoma. I presume you are R handed. With stereotactic guidance nearly all are technically resectable with micro neurosurgery, but decision is based on the benefits versus morbidity.
Cavernomas typically present with neurological deficits from repeated bleeds and epilepsy.
Dr Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre/ ANOC Neuroscience and Orthopedic Centre
Dear Dr Lee,
My mum has been diagnosed to have a hemifacial spasm about 10 years ago. Initially, she had several botox injections as recommended by her physicians in Penang. However, as time goes, the effect worn off and now the disorder has came back again.
Is it necessary for her to have a surgery to cure this once and for all? Can we please have your opinion on this?
Many thanks for reading and I look forward for your reply.
Best wishes,
Kheng
Dear Kheng,
Hemifacial spasm after failed Botox injections can be cured with micro vascular decompression ( MVD ). This is a very safe and elegant operation when done by experienced neurosurgeons. This is however not a new operation as it has been described by Dr Peter Janetta since the late 1970’s and popularized since the 80’s. Techniques have improved over the years with the advent of better instrumentation and intraoperative neuro physiological monitoring.
This has been the mainstay of treatment for hemifacial spasm for decades until the advent of Botox which works in some cases, at least in the early stages. The only downside of surgery is potential hearing loss on the same side and this is minimized by monitoring BAEP during the operation. Success rate should be more than 85-95% with equal percentage of patients remaining free from symptoms even after 10 yrs.
Surgical incision is behind the ear, hence hidden when the hair has re-grown. The artery loop which compresses on the facial nerve near the root exit zone is displaced away from the nerve with either a small Teflon Or muscle graft. Surgery takes 1and 1/2 hrs, and requires a few days of hospitalization.
I hope you fine these information useful.
Dr. Lee Foo Chiang
MBBS, FRACS ( neurosurgery )
Consultant Neurosurgeon
Sunway Medical Centre / ANOC Neuroscience and Orthopedic Centre
Dear Dr Lee, I am suffering from HFS for 3 years and taking Botox injections every 3 months (in Seremban) to reduce the spasm. But now the spasm is getting stronger and still there even after the injections. May I know how much is the cost of MVD?
Dear Mr. Khairul,
Micro vascular decompression (MVD) for hemifacial spasm after failed Botox treatment is a successful operation in experienced hands. It is reimbursable by medical insurance.
Please see your email for further details.
Thank you.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Center.
Hi Dr. Lee,
I realized a bump on my head about 9 months to a year ago but didn’t think much of it hence did not do anything about it. Over last weekend, I realized that the shape/size may have changed. I just did an MRI scan and have been diagnosed with osteoma.
Findings:
– my movements are intact and there’s no pain on the bump itself
– no focal space occupying lesion detected within the brain paranchyma
– there is thickening of the outer cortex – 2.5cm x 1.9cm at the right frontal bone of the skull with no soft tissue component
– apparently there’s no intracranial bleed or mass lesion – inner cortex, brainstem and cerebellum appears to be normal as well
– grey and white matter appears to be normal
– midline is central and no evidence of hydrocephalus
– DWI is normal for an acute infarct
– pituitary gland and corpus callosum appear normal
– the lesion is seen in the outer cortex, and is most likely benign (but the radiologist is unwilling to guarantee that it’s 100% benign unless it’s removed or tested)
Some questions I need your advice on:
– since i’ve been told that it’s entirely on the outside of my skull, is there any way it could have been giving me headaches and causing dizziness? i’ve been getting is very easily in the past year but i’m not sure if this is the cause of it.
– it’s not noticeable as it’s under my hair, right at my hairline. what are the chances of it continuing to grow and if it’s advisable to remove it now?
– if i choose not to remove it, will it eventually encroach into the skull and brain? if yes, what does that part of the brain control, which will determine the risk of removing it only then?
– if i choose not to remove it, is a yearly scan required to keep track of the size? the doctor i met with requested for me to monitor over the next 2-3 months to see if it’s growing fast. but is monitoring by touch sufficient to feel the growth?
– i read that most osteoma are benign. is this true and should i worry about it being otherwise?
(Actually, I’m most concerned about whether or not it’s causing my headaches and if it will continue to grow hence I should remove it now, even if it’s not causing me any pain)
Thanks.
Sharon
Dear Sharon,
Thank you for your enquiry.
What you have is Ivory osteoma. This is benign and involves only the outer table of the skull. Ivory osteomas do not cause compression of the underlying brain. They may increase in size but do so very slowly. The only indication for surgical removal is cosmetic, for those occurring in front of hairline and are hence unsightly.
I hope these informations will be of help to you.
Regards.
Dr Lee Foo Chiang
Consultant neurosurgeon
Sunway Medical Centre/ ANOC- advanced neuroscience and orthopedic clinic.
sir my mother is suffering from bulbar onset motor neuron disease , is there anything to help her
Dear Riik,
MND is basically a neuro degenerative disease with no known definitive treatment.
The pain on the right side of the body may be managed symptomatically with medications like Myonal, Lyrica and Norgesic.
Best wishes.
Dr FC Lee
Dear Jack,
The mainstays of treatment for motor neuron disease (MND) are active exercise and physiotherapy together with maintenance of proper nutrition. Your mother would benefit from swallowing assessment by her doctor, with assistance from a speech/swallowing therapist. They can advise on the steps needed to maintain oral feeding.
There is no curative medication; you need to discuss with her doctor whether she should take the drug Riluzole.
Best wishes.
Dr Lee Moon Keen
Consultant Neurologist
on behalf of Dr Lee Foo Chiang, Consultant Neurosurgeon
hi sir my aunty diagnosed Bulbar onset MND , she is facing little trouble in breathing and when she talks her nose stops , she also have some pain in right side of body , can you help me
Hello Doctor Lee,
My brother-in-law collapsed this morning and currently in the ER of Hospital Tengku Ampuan Rahimah, Klang. He had brain tumor years ago and was successfully removed but not all. 3 weeks ago, he complaint of hiccup that won’t go away. We did not see it as something serious but now he’s in a coma.
I asked some doctors i know and it is possible that the tumor is back. The hospital just did a CT Scan on him and we are currently waiting for the result.
Can you please advise me what we need to do?
Thank you.
Dear Encik Ramie,
Thanks for your e-mail.
What was the nature of the tumour? Was it benign or malignant?
CT scan should show what is the underlying cause for the coma, whether it is related to the tumour or was there a separate reason like intracranial bleed or stroke. Normally when in urgent situation like this, the CT scan is done as an urgent test and result will be known immediately so that urgent action if needed may be taken ASAP.
Do discuss with the neuro.
Dear Dr Lee, I have been diagnosed with ” cervical stenosis – C4/ C5 last week. Currently, my right hand is a bit “weak” and my right leg feel numbness. Is it normal for those having this stenosis problem? Secondly, I also notice my speech is also efffected .For example, i wanted to say “makan ” but i said “macan”. Whether cervical stenosis can effect speech as well? My fisioterapist also told me that for C4/C5 stenosis “traction technique” is not adviseble. Is true doc? Really need your advise and thank you in advance.
Dear Yang,
Thanks for your e-mail.
Cervical stenosis with spinal cord and nerve roots compression is usually due to a combination of disc herniation, swelling of the ligament and facet joints. If the former is a major contributor to the problem, microsurgical (endoscope assisted) removal of the disc with decompression of the nerve root canal will lead to prompt relief of the symptoms. In patient younger than 65-70 yrs, a mobile disc replacement is inserted. Older patient will have inter body cage implanted instead.
The other option is to do a decompression from the back of the neck (cervical laminoplasty and neural foraminotomy).
These are commonly performed operations by neurosurgeons and takes between one and half hrs to 2 or 3 hrs depending on the number of levels involved.
Most patients are allowed to walk the next morning and go home the day after.
Hope you find these informations useful.
Regards.
Dr Lee Foo Chiang.
Consultant Neurosurgeon
Sunway Medical Centre
03 74910777 03 74919191ext 15519
Hi Dr Lee,
I am experiencing involuntary muscle contraction of my right face for a year plus. Have consulted general practitioners and most were telling that was due to long hours on computer or insufficient sleep. Have consumed some Vitamins precribed by doctors and have gone through acupuncture treatments. It does not help much,
Read from some forums (and your post above), Micro vascular decompression surgery is a better option to cease facial spasm. Would appreciate if you could let me know how much roughly is the cost of the surgery and how long would it take in terms of recovery?
Thank you.
Dear JC,
It appears you have hemifacial spasm. This is usually due to an artery (blood vessel) compressing on the facial nerve at the spot where it leaves the brain stem. Botox injections by neurologists may give temporary relief but needs to be repeated every few months. Micro vascular decompression operation was first described by Dr Peter Janetta in the late 70’s is now done regularly by neurosurgeons is a definitive treatment leading to long term and permanent cure in most cases.
Please see your email for personal reply. Thank you.
Dr Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre
03-74910777, 03-74919191 ext 15519
Dear Dr
I’ve got pain in my back.A.Shock sensation in the lower spine for 30 seconds before i can move.Can i go have a quick check up in Ipoh or can you point me where to go next.Thanks
Dear Mr Cheah,
You may go to a hospital in Ipoh see a neurosurgeon or orthopedic (spine) surgeon. MRI lumbar spine is necessary.
Best wishes.
Dr FC Lee
Consultant neurosurgeon
dear Dr lee
我的爸爸得了重症肌无力（myasthenia gravis），他也有胸腺瘤，可是他没有呼吸困难，请问我应该去找你吗？
Dear Eiona,
Myasthenia gravis 通常治疗由神经科专家。请询问您的医生，一个适当的转介。最良好的祝愿。
Webmaster.
Dear Dr Lee,
I am 41 years old. It has been few years since I have headache at the back of my head, it is not so much of the pain but the feeling of heaviness at the back of my head. Recently I have been feeling numbness and tightness on certain part of my head and occasionally have numbness or pin and needle sensation on my fingers and feet. Which specialist should I visit and I wish to do a thorough brain check. Do you recommend MRI to be done. Thank you.
Dear Ms Ang
Your symptoms need to be evaluated clinically. Your GP would be able to assess and advise on whether you should see a specialist, and if so, which area of specialty. Following on that, decision could be made about the need for MRI.
Best wishes, Webmaster.
Dear Dr Lee Foo Chiang,
i was referred from your patient and would like too know more on Endoscopy minimally invasive microvascular decompression surgery for hemifacial spasm.
Best regards!
Andrew
Dear Mr Choo,
Thank you for your enquiry.
Micro vascular decompression for hemifacial spasm is done via a skin incision behind the ear. A small craniotomy (bone opening) is made. A small piece of Teflon or as I normally prefer, a tiny 0.5 cm cube of patient’s own muscle graft taken after taking the skin incision, is interposed between the facial nerve and the compressing blood vessel loop.
This usually result in immediate and long term cessation of the facial spasm in 85-95% of cases. This is an extremely safe procedure if done by experienced surgeons.
Regards.
Dr Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre.
Hi Dr Lee
My mum diagnosed with pituitary macrodenoma. What will be the estimated cost for this surgery in private. She has medical complication such as diabetes and BP. She is 59 yrs old. What will the after effect after the surgery.
Thanks
Dear L, Please see your email for a private reply.
Best wishes.
Dr.Lee
医生，最近我背后腰骨痛，然后睡觉，或向地下拿东西也有痛。有什么治疗方法？可以email 我location 联络号码？
Dear Mr Tai,
这种症状多数是腰椎骨椎间盘突出挤压到神经线导致。需要照MRI lumbar spine.
Thank you.
Dr. Lee Foo Chiang
Sunway Medical Centre
03-74910777 or 03-74919191 ext 15519
or
ANOC – Advanced Neuroscience and Orthopedic Clinic. Lot 2.02 (East Wing), 2nd Flr, Menara BRBD, 285 Jln Maarof, Bkt Bandaraya, Bangsar (behind Bangsar Shopping Center), 59000 KL.
+60 3 2282 6027
Hi, I was wondering if you are a the type of neurologist who can test and diagnose children with ADHD. If not, should you be able to point me in the right direction, that would be much appreciated.
Dear Kerry, You need to consult either a Child Psychiatrist or Paediatric Neurologist. Please refer to the National Specialist Register http://www.nsr.org.my/specialties.html
Best wishes.
Webmaster.
Dear Dr. Lee,
我妈妈的膝盖生骨刺，请问有什么办法可以治疗？现在她上下楼梯都很不舒服。我妈妈有动过子宫切除手术，会不会是这个因素影响到我妈的脚软骨退化？
有听人说可以把类似像软骨的东西注射进去膝盖，是吗？
谢谢！
小玲
Dear 小玲
你妈妈的膝盖关节的问题可见骨科医生，李润强医生（无亲属关系） Dr Lee Joon Kiong ANOC +60 3 2282 6027 Lot 2.02,(East Wing) ,2nd Flr, Menara BRBD, 285 Jln Maarof, Bkt Bandaraya, Bangsar (behind Bangsar Shopping Center) 59000 KL
Malaysia
谢谢。
Dr FC Lee
Good day Dr Lee,
My son, 9 years old has been detected of having kyphoscoliosis recently. Appreciate your advice on any possible diagnosis and treatment to this.
Thank you
Dear Raynovak
For specific and meaningful advice, your son needs a detailed clinical assessment by a spine surgeon. Please consult your doctor to arrange for this consultation.
Best wishes.
Webmaster.
Hi Dr. Lee,
I am 42 years old. I found swollen on my left back body about 6 months ago when I went for massage. My GP told me that it is just muscle problem and ask me not to worry. But lately, about 2 weeks already, I feel numb on my two fingers (Thumb and Index finger) quite frequently everyday. I am worry that this has something to do with my swollen back. I also have a bad sour shoulder 2 years ago. My relative suggest me to go for a MRI scan.
My question to doctor, Is it necessary and how much will it cost me to do the scan?
Thanks,
John
Dear Mr. Jong,
There are a few possible causes for your thumb and index finger numbness. It can be due to a cervical (neck) disc protrusion compressing the nerve roots. There is usually associated neck and shoulder soreness/stiffness and arm or forearm pain. The other equally common cause will be entrapment of the median nerve at the wrist. Non surgical problem e.g. Inflammation / degenerative conditions of the nerves can also lead to your type of symptoms. Investigation with MRI cervical spine and nerve conduction study (NCS) will help to confirm the underlying problem. The former cost RM 750-1,000, while the latter about RM 500-600. These are estimated costs and vary from hospital to hospital. You may call outpatient centers which are generally cheaper like ANOC +60 3 2282 6027 for the cost and appointment.
Hope these informations are of help to you.
Dr. FC Lee
Consultant neurosurgeon
Dear Dr Lee,
This is Joanne, my aunt is get stoke about 2 weeks ago, this affected to her left body and get Incontinence problem. Below is her CT brain scan result.
CT Brain:
Plain and post I’VE contrast.
There is an illdefined hypodensity in the right temporal and frontal lobes, basal ganglia and internal capsule. No enhancement shown. There is mass affect with compression of the right lateral ventricle. The appearances are not typical of infarction or encephelitis. The likehood of glioma exists. Normal brainstem and cerebellum.
Summary:
Illdefined hypodensity in the right temporal and frontal lobes, basal ganglia and internal capsule, possibly glioma.
I hope to get yr proffesional advice, thanks.
Best regards,
Joanne
Dear Miss Chin,
You have not mentioned your aunt’s age.
The scan seems to indicate a type of primary brain tumor, glioma, which in the adult (middle age and above) is malignant in > 50% of cases. It appears to be quite extensive. A confirmation of the diagnosis is useful before deciding on further steps. This can be done through a small operation via a small burr hole under computer guidance. Conversely partial resection and sending the tumor for diagnosis will offer some relief in her symptoms and prolong survival. MRI brain with contrast usually allows neurosurgeons to make a reasonably accurate clinical diagnosis.
Hope you find thisinformation useful.
Do bring the MRI/CT and your Aunt to see a neurosurgeon for a clearer discussion and assessment.
Regards.
Dr Lee Foo Chiang
Dear Dr. Lee,
Good day! I have a 2 years old daughter who had diagnosed with thoracolumbar scoliosis with convexity to the left (30 degree) since September last year. My doctor advised to wear brace for 20 hours everyday. What causes this? What treatment is suitable for my daughter?
Please advise. Thank you very much.
Dear Connie,
Most of the kyphoscoliosis are idiopathic.
Has an MRI thoraco-lumbar spine been done to exclude underlying etiology?
Wearing a brace is advisable in the active growth age to prevent worsening of the scoliosis. He should be seen by orthopedic-spine surgeon/ pediatric orthopedic surgeon but needs a pediatric neurologist to monitor in case of any neurological deficit developing.
Good luck.
Dr FC Lee.
Dear Dr Lee, greetings to u. At this current moment i am having a very situation where my father in law admitted due to a fall. his diagnosis is according to the Dr that his brain now is dead due long hours blood clot. And i was told that he only have 10% of recovery. He is also suffering on diabetic and high bp. His last reading before the fall is 250/150. What is your advice? Should i ask the Dr to operate him? He is now depend on the machine to feed him the oxygen. Tks Dr Lee
Dear Mr Hoi,
I am sorry to hear that your father in law is in such a critical condition.
“Brain death” is a state where there is no evidence of detectable brain response to clinical testing. A strict guideline is followed to confirm the diagnosis of brain death after excluding metabolic or medical co-morbidities like electrolyte imbalance, hypoglycemia and hypothermia etc.
Brain death certification if properly performed, is a legal definition of death and signals the beginning of irreversible death process.
It is a contraindications for any surgical intervention as it will be futile to do so.
Thank You.
Dr FC Lee
Consultant Neurosurgeon.
Dear Dr. Lee,
Good day.
Seeking your advise for my daughter’s condition.
My daughter born prematurely at 32wk 3 days at 1.8kg. She was infected by E.coli after 5 days since born. Treated as Meningitis case with 6 weeks of Meropenem treatment, plus 2 weeks of Amikacin. Total 42 days.
Her weight is now at 3.65kg, breast-feeding at 100ml every 2-3 hrs. Feeding well and active.
Today, we have been told that the baby is confirmed hydrocephalus after a series of ultrasound and CT scan. Suggested to putting a shunt in the brain asap.
CT scan result shows below:>>
The lateral and 3rd ventricle is grossly dilated except the left occipital horn.
The left temporal horn is relatively more dilated than the right.
Associated periventricular hypodensities represent seepage of CSF fluid.
The 4th ventricle appears as normal.
Evidence of loss of volume in the left occipital.
The calcific foci in the left occipital noted.
No significant midline shift.
Obstructive hydrocephalus level of obstruction likely aqueduct.
Previous insult of left occipital.
What type of shunt is most suitable for baby? Fixed or variable?
We urgently need your advise and would appreciate if we can reach you via phone or appointment.
Thank you.
Dear Mr Theng,
Thanks for your e-mail.
We tend to use low profile, low pressure VP shunt. Sometimes programmable shunt is used as it allows for pressure adjustments of the shunt in the outpatient setting as the child grows and the intracranial pressure requirement changes with age.
Regards.
Dr FC Lee
Consultant Neurosurgeon.
Dear Dr Lee, my dad had brain stroke and treated in icu sunway medical centre now, i wish to know will stem cell therapy help with his situation. My dad is breathing on his own now and there is movement from his eye balls and eye lid. His leg is reacting to pain now.
Dear Melody,
Please see your email for private reply.
Best regards.
Hi Dr Lee,
I’m Dr H, thank you for the phone conversation with you last week regarding my uncle Mr.Eddy from Banda Aceh, Indonesia who was diagnosed to have Glioblastoma grade IV after an operation for the spontaneous ICB. After a long discussion between family members and relatives, he is keen to proceed with the treatment offered, namely cyberknife stereotactic radiosurgery followed by the conventional radiotherapy plus the chemo with Temozolomide. We realize that it is important to start the treatment asap when the patient’s general condition fit enough for the procedure however, in view of his financial difficulty there will be a delay in order to gathered help and contribution for his treatment. I’ll be grateful if Dr Lee could provide me some information/data regarding this treatment based on your experience. Is this a definite treatment or a palliative to prolonged life? How many years the survival rate could be prolonged? if this treatment has a potency to cure, how many percents of the successful rate and the relapse (for grade IV glioma)? How many percents of these patients need a debulking surgery after the treatment? As the treatment as well as the prognosis is important to come in between the risk, cost and benefits consideration for Mr. Eddy who unfortunately live in a non-ideal world. Thank you.
Sincerely,
H Lee
Dear Dr H Lee,
Thanks for your e-mail.
Concurrent therapy (post surgical debulking) of glioblastoma / malignant astrocytoma using Temozolomide and radiotherapy/radiosurgery is a palliative treatment aimed at prolonging interval between tumor recurrences and improving quality of life.
Mr. Eddy’s tumour fortunately is located in the “silent” part of the brain (Right frontal lobe). This makes it amenable to further repeated resections without any significant neurological deficit should the inevitable recurrence occur, thereby prolonging quality life.
I hope these informations will be helpful to the family in their decision making.
Warm Regards.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
MBBS, FRACS( Neurosurgery)
Hi Dr Lee, My wife have been suffering from shoulder pain problem starting from tight muscle and progressively to severe shoulder pain.This has been going on for more than 6 months already. She has undergo conventional drug treatment, physioteraphy, chiropractic and accupuncture but does not seem to help. Xray and MRI shows minor disc bulge at C6/C7. Only Lyrica 75mg can control the pain temporary and not Celebrex. I seek your expert opinion what should I try next ?
Dear Mr Lee,
Thank you for your enquiry.
Apart from neuropathic pain due to nerve root compression, other possible causes of her pain include fibromyalgia, myofascitis and osteoarthritis or frozen shoulder. Sometimes a “small” cervical disc may be associated with narrowing of the neural foramen (nerve root canal) leading to neck, shoulder and arm pain. A good quality MRI with thin slices over the disc spaces should be able to detect this. Nerve conduction studies is sometimes useful to elucidate the problem.
Lyrica is useful for neuropathic pain and fibromyalgia, She can see a neurosurgeon familiar with cervical spine surgery.
Hope your wife gets relief from her pain.
Thank you.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
Dear Dr Lee,
I am Mohammed Muntasir mamun from Bangladesh.My younger brother is having Paraplegia.The accident happened 3.5 years back .He spine was broken and cmpressed,now it is attached with a permanent steel rod.I took him abroad for treatment.The Doctors said he has little chance with stem cell treatment.I would be happy to know if Malaysia can do something with stem cell treatment.
Thanking You
Dear Mr. Muntasir, we are sorry to hear of your brother’s unfortunate injury. For information, stem cell treatment is not approved for spinal injury in Malaysia at this time.
Dear Mr. Lee,
I would be very grateful if you would kindly advise me re: management of my niece condition. Currently,she is aged 13 years old.
She had a left arachnoid cyst & swelling noted at 2 months old which was subsequently drained in Johor Bahru. The swelling returned,with sunset eyes & projectile vomiting followed. A shunt with a tube were inserted in KL GH.
My niece recalled at approximately since 9 years old, she presented with the odd headaches once a week/month.Her parents were informed in clinic it is quite normal to have the odd headaches for her case.
Till recently since last July 2012,her frequency of headaches became more frequent & was accompanied with giddiness & imbalance on mobilising, nausea & vomiting. Certainly, this couple of months she is having these symptoms on a daily basis with headaches/giddiness lasting 2-6 hrs with some relief when she lies down & rest.She mentioned paracetamol does not help.
About 4 weeks ago she had a fit in the classroom, frothing around the mouth & went unconscious. Her teacher called for an ambulance & she was taken to Klang GH being the nearest hospital. She was observed & was discharged after about 4 days in Klang hospital.
A CT scan was done on the 4/01, & an MRI performed on the 17/01/13.
On the 25/01/13,besides all the other symptoms she complained of, she mentioned her left side of head is numb while in school.
After the 17/01/13, she had 6 episodes of going rigid for short spells & could not move or talk. Occasionally, both her arms felt numb. On one occasion, a moving, floating pencil coming towards her. She was terrified following those experience.
Would really appreciate your advice.
Thank you so much.
Dear M lee,
It looks like she had a cysto peritoneal shunt inserted during infancy. Headaches relieved by lying down can be due to over drainage of the shunt which had to be of the low pressure type since it was implanted during infancy. The CSF pressure requirement changes with age, being higher as we grow older. A programmable shunt allowing for pressure adjustment in the outpatient clinic will be an advantage. In any case she will need at least to have the shunt abdominal tubing lengthened as she would have out grown the short length of tube inserted as a baby, now that her pubertal growth spurt should have started. Too short a tubing, and sited outside the abdominal cavity also renders the shunt to fail. Useful to review the recent MRI scans.
Epilepsy can be managed by Neurologists or neurosurgeons with anti epileptic medications.
Hope your niece gets well.
Regards.
Dr LEE Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre / ANOC Neuroscience and Orthopedic Centre.
Hi Dr. Lee I have a 1cm cavernoma in the lower left parietal lobe, in the corona radiata area, 5cm deep. i have leg weakness, toe numbness, and balance issues for 2 months after a bleed after having the flu with previous minor bleeds.
is the cavernoma in the motor region or sensory region? is that the reason why neurosurgeons said not to operate because of the possible deficits?
there seems to be fissures leading to the cavernoma, will this reduce damage to brain if surgery is required? around 3cm leading to the cavernoma.
i hear gamma knife is not recommended.
please advice. many thanks
Dear Ping,
One has to weigh the benefits versus side effect in any treatment. Un ruptured Cavernous in sensitive/ eloquent areas tends to be managed conservatively. If there has been repeated bleeds, then the approach may be different. Stereotactic radiosurgery with Cyberknife or Gammaknife is believed to be useful by certain groups of doctors particularly those from Pittsburg USA, but doctors from Karolinska, Sweden, the birth place of Gamma knife radiosurgery is against it saying it does not help. I treat them sometimes with Cyberknife in ruptured case where surgical removal is an absolute no. Stereotactic micro neurosurgery allows for resection in majority of cases. Transulcal approach can be planned preoperatively on the Image Guided Stereotactic system. This will shortened the depth of cerebrotomy and we can also chart a safe surgical tract to the target. You have had repeated bleeds. Each subsequent bleed may lead to compounding neurological deficits.
Hope these reply with be of help to you.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre/ ANOC Neuroscience and Orthopedic Centre.
My brother had his brain surgery due to stroke last Saturday at UKM. His condition seems worsen after the operation. I have d queries below :
1) Can we transfer him to another hospital ? cos he just had his brain operated last few days.
2) He has fever today. And his eye was swollen. Cos doctor tried to insert pipe into his nose then pulled out the pipe again dat cause his eye swollen.
3) He falls asleep easily within minutes. Is it a norm dat d patient tends to fall asleep easily after brain operation ?
4) He has problem to swallow food.
5) Will it be danger to move him around if we transfer him to another hospital ?
Hope to hear from you very soon…many many thanks !
Dear Amy,
Please see your email for a private reply.
Best wishes.
Hi Dr.Lee,
May i know if my mother, an Inoperable GBM patient having brain swelling (oedema), is that any solution to treat instead of taking steroid? Operation advisable? Will the operation affect the quality of life? I’ll really appreciate your best opinion on the above. Eagerly awaiting your advise and thanking you in advance.
Dear Samantha,
Sorry to hear about your mom’s condition.
Surgical decompression (partial excision) of GBM to alleviate the effect of raised intracranial pressure from swelling around the tumor is a feasible short term solution if the tumor is located in a dispensable part of the brain e.g. R frontal lobe. Sometimes we will intentionally resect the frontal lobe up to 8 cm or put a self regulating drainage tubing (vp shunt) to offer the tumor room to swell as it grows inevitably. However the tumor being aggressive and grows rapidly the benefit of these measures is at best short term although it improves the patient’s quality of life in the interim period.
Kind Regards.
Dr LEE Foo Chiang
MBBS, FRACS ( Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
603-74910777, 603-74919191 ext 15519. ANOC Neuroscience and Orthopedic Centre
+60 3 2282 6027
Dear Dr Lee,
My father (aged 65) was involved in MVA on 8th Dec 2012 which resulted in multiple SAH. CT scan was done in Hospital Temerloh 4 hours after the accident and was advised by neurosurgeon in HKL that surgery is not required and to place him under conservative treatment. A repeat CT scan was done 24 hours later and no further scan is taken after that. Apparently the second scan showed more blood but we are unsure why no further scan is performed to ensure the hemorrhage is not worsening. He was comatosed for almost one week and tracheotomy was performed.
He was discharged from hospital on 5th Jan 2013 and is now recuperating at home. He is able to recognize most of us, able to move his arms and legs, but we noticed very little movement of his right leg. However, sometimes he would talk gibberish. He sleeps very little, even at night and would moan non-stop and we do not know whether he is in pain. We started him on Lexotan 1.5mg 2 nights ago, given at around 10PM. The first night, he slept longer. But the second night, which was yesterday, he had trouble getting into deep sleep and woke up every 30 mins.
Kindly advise as to whether a CT scan is required and whether we need to consult neurosurgeon, ENT specialist or any other specialist.
Dear Soo Sun,
A repeat CT Brain scan is clearly indicated to see what is happening to the intracranial hemorrhages as sometimes these can evolve into chronic subdural hematomas causing compression of underlying brain. This is especially so with the elderly. Have a CT Brain (with iv contrast ) at the nearest hospital. See a neurosurgeon for assessment and if indicated for the evacuation of the clot if any.
Wish your dad well on his recovery.
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre/ ANOC Neuroscience and Orthopedic Centre
603 74910777, 603 74919191 ext 15519. 03 2201 9291
Deare Dr. Lee,
My dad had fallen down and had been undergone brain surgery on 27/Nov. He has been unconscious since then. You are introduced to me by friend. May I make an appointment to seek you for opinions on my dad’s CT scan reports?
Thank you.
Dear CY, Please see your email for a private reply.
All the best.
Thanks, Dr.Lee.
李医生您好，我姐姐的儿子今年13岁，前天发现他左眼看不见，昨天带他去医院检查发现他有puritary tumour 大约有 4cm大，医生诊断说他的左眼已经丧失95%的视力，现在右眼也丧失了40%的视力。情况很紧急，由于我们住在jb, 想请问这两天是否能够安排见见您？
Dear LYS, please see your email for a private reply.
All the best.
Dear Dr. Lee,
I have ringing left ear and right ear with some strange noise like bending paper on my right ear for 9 months(hearing lost at left ear), feeling dizzy for 4 yrs. had been visit 2 doctor but only provide Vit B and ginko 40mg. Is there any other method to help me out of this condition ?
thanks
Dear Paul,
You will need to exclude the remote possibility of a benign tumor arising from the vestibulo-cochlear nerve i.e acoustic neuroma before concluding it is due to other more common conditions like Meniere’s disease. A good quality MRI with contrast enhancement would be able to do that. It is then safe to just continue with symptomatic treatment with medications
Thank you.
Dr. FC Lee
Consultant Neurosurgeon
ANOC Neuroscience and Orthopedic Center.
Menara BRDB, Jln Maarof, Bangsar, KL 03 2201 9291
Dear Dr Lee,
My friend was diagnosed with Squamous cell carcinoma (SCC) with a 0.44cm on her tongue and wonder your clinic offer Laser Microsurgery For Tongue Cancer ?
Dear Jason, your friend needs to consult an oral surgeon for advice.
Best wishes.
李医生；我是那天星期二早上给你开刀背椎骨的那位病人， 我在医院时没觉得我的伤口和大腿有那痛。直到回家的星期五晚上时感觉伤口和大腿很痛；連睡觉都难吃了止痛药都不行。请问我该怎样才好。 From Md Tan Siok Ha
Dear Madam Tan, please see your email for a private reply.
Dear Madam Tan, our message was rejected by your email provider. Please call Dr Lee’s clinic for help and advice.
Best wishes,
Webmaster.
Dear Dr Lee:
我是宝珍（53岁）在1年前～我早上起床的时候，发现嘴唇歪还有一只眼睛盖不完。当天我的血压是170。经过这一年来的调理看医生吃药和针灸慢慢就有好转，可是没有完全的痊愈。现在的状况是右边头部的部位一直拉的很紧，导致右边的脸部也麻痹很不舒服。
可是医生说我扁头痛，我想寻求您专业的意见？帮我脱离这痛苦。
问候女士，你的问题是相当复杂的。请询问您的医生转介到专科医师作进一步研究和提出意见。最良好的祝愿。
代表:
Dr Lee Foo Chiang
Consultant Neurosurgeon
Dear Dr Lee,
我是丽芬，今年33岁，是位小学教师。从今年三月份开始我的腰就显得很无力，时常腰酸背痛，坐久右边臀部会有酸麻的感觉；站久之后要蹲下如厕时，腰骨很痛，需要慢慢地弯下。我做了MRI，报告一切都正常。为了治好它，我看了中医、不时做全身按摩、脚底按摩……但这些只能够减轻我的痛而已。我想寻求您专业的意见，帮我脱离这痛苦。
丽芬
丽芳，
我觉得最好你能让神经外科医生檢查也顺便看看你的MRI ,才能够下定论。
謝謝。
李富强医生
Dr. Lee Foo Chiang
Consultant Neurosurgeon
Sunway Medical Centre
Tel 603 74910777, 603 74919191 ext 15519
g’day dr. lee, two days ago, my bro felt dizzy and throw out a couple of times, then we admitted him to local pantai hospital in batu pahat, and we were referred to pantai hospital for neurosurgeon specialist. both MRI and CTscan hv been performed. would it be ok if we send reports to you tomorrow for your advice?
million thx in advance.
additionally, my bro just diagnosed with a large pituitary tumour, extending into sphenoidal sinus and suorasellar cisterms…eyes vision hv been affected.
Dear Ee Wai,
Most pituitary rumors can be removed by neurosurgeons through the transphenoidal approach without having to open up the cranium (skull). See a neurosurgeon familiar with this technique. The patient needs to stay for 2-3 days post surgery in the hospital. Your brother need hormone replacement if the tumor has affected his pituitary gland secretion.
Dr. FC Lee
MBBS FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Hi Doctor I am Eric Lian .I had been suffering from slipped disc for about 8 months.I had been seeing doctor and done the pyhsio for 2 months but i cant see any result.Should i go for surgery ? As i can felt numbness from my right leg and 2 finger .
Dear Eric,
We need to assess your condition clinically and whether MRI has been done to confirm the slipped disc which can occur in either the low back or neck level. Generally after an adequate trial of conservative treatment meaning physiotherapy and medications, microsurgery (endoscope assisted microlumbar discectomy) is recommended. With good outcome, patients start walking the next day and are home the following day pain free.
Dr. LEE Foo Chiang
MBBS, FRACS( neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
03-74910777, 03-74919191 ext 15519.
Hello Dr.
I have the symptoms of GERD and IBS for last few months. Recently for the last 2 or 3 days, i have been experiencing tingling sensation or prickling pains all over my body. feeling weak and kind of unexplained pain in my muscle joints, arm wrists. Also finding numbness in hand/fingers during sleep.
Can you please help me what might be wrong, and which specialty of doctors i need to consult?
Dear Ravi, perhaps you should follow up with the doctor whom you are consulting for GERD and IBS, in order to understand your new symptoms in the context of your current treatment. This doctor would be in a position to advise on the necessity of referral to any other specialist.
Best wishes, Webmaster
Hi Dr.,
I recently had a CT scan done on my head and incidentally it showed that I might have a cyst on the left of my brain. Further I was referred to get an MRI and the findings were an arachnoid cyst about 3cm x 4cm. I suffered from child migraine when I was young and never found a cure and just grew out of it. I don’t really know what real dizziness, fatigue, nausea, headaches, vertigo, blurry vision at times, lost of focus is anymore as I have lived with all this problems and never let it stop me or even think it was anything. The neurosurgeon that saw me proposed that I go for a endoscopic surgery to puncture it. On the one hand he says it’s not urgent and on the other he is asking me to do it soon.
I would like to get a second opinion and would appreciate an appointment with you if you could give me an opinion.
Thanks heaps
Dear Miss Paige,
Arachnoid cysts of the brain are congenital and are often seen as incidental findings on MRI or CT scan done for other reasons. Unless it is sizeable and causing symptoms like headaches nausea/ vomiting or rarely epilepsy, it can be left alone. If treatment is needed, neuro-endoscopic fenestration can be done as an option, failing which craniotomy microsurgical excision of the cyst wall or Cystoperitoneal shunting can be considered.
Hope this information is of help to you.
Best Regards.
Dr LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Dear dr,
My mom has encounter stroke due to blood vessel rupture in her brain. She is now admitted to HKL and an operatoon has been performed to remove blood in her brain. However, the doctor inform us that the ruptured vessel is still unknown and what can be done is to control the blood pressure. My mom’s blood pressure once rose to 200 for systolic this morning and can only response to pain. Is there any other treatment so that my mom can get past the critical state?
Thank you.
Dear Miss Yong,
Bleeding in the brain can be related to fragile blood vessels due to a process called atherosclerosis, usually in the presence of diabetes or high blood pressure. The other reasons for bleeding will include burst cerebral aneurysm, a small ballooning of blood vessel of the brain and rarely secondary to tumor, AVM etc.
The CT Brain scan usually allows us to differentiate between the different types of bleed. MRI will exclude tumor or AVM, a congenital abnormality of the brain vessels. If necessary, we do an angiogram to rule out ruptured cerebral aneurysm or AVM. If the tests are all negative, and the clot is small < 3cm, surgical evacuation may not be necessary. Physiotherapy will then play a main role in her treatment in addition to control of hypertension/diabetes.
Hope your mother gets better soon.
Regards.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
Hi Dr Lee,
I would like to seek your advise regards my mom is got a mild stroke 2 years ago , body movement not much affected but just feel lympness and weakness on the right side hand and leg movement . She got depression and anxiety too due to family problems.
She is also taking nuerobion injection at clinic for recovery. It gets better all the while till recently this 3 months she got a complaint the sciatica nerve pain at the hamstring area.
Lost appetite , lost weight and lost the sensation of touch also.
I am very worry n I don’t know what to do. Do I need to bring her to see you on her condition?
I am looking forward to hear from you .
Thank you !
Melissa
Dear Melissa,
Thanks for your enquiry.
We need to see whether her sciatica is due to prolapsed lumbar disc as is in most cases, or is related to her stroke.
Certainly this will further impair her mobility which is of paramount importance to her.
You are most welcome to bring her to see me either at Sunway Medical Centre 03-74910777, 74919191 ext 15519 or at ANOC Neuroscience and Orthopedic Specialist Centre, Level 2, Menara BRDB, Jln Maarof, Bangsar ( behind Bangsar Shopping Center 03-2209291.
Regards.
Dr. LEE Foo Chiang
Consultant Neurosurgeon
Hi Dr Lee,
My mother was diagnosed with a brain tumour at Ipoh GH on 26 Sept 2012. The diagnosis upon 2 repeated CT scans is as follows:
“On examination, there is no obvious neurological deficit. CT Brain scan done showed calcified mass in left parietal occipitol region with scalloping of overlying bone. No ICB and basal cistern is patent. Diagnosis of left patieto-occipital meningioma is made”
She has been complaining of dizziness, headache and balance problem since May, and since she had a history of a vertigo problem i brought her to an ENT and it got a bit better in a month or so. But in July her left limbs started getting week, and her left arm started shaking badly, and hence the trip to the hospital on 26 Sept 2012 gave us the above news. She now complaints of severe headache and head feeling rather heavy, making it difficult for her to move around.
As I am residing in PJ, i’d rather consult a doctor here than in Ipoh. I’ll really appreciate your best opinion on the above, on what can be done to treat this; medication? surgery?
Also, Ipoh GH has planned for her MRI only to be in December. If I’d rather do it here at my own cost, how much would it be? If you need to see her to advice further, I’m willing to make an appointment.
Eagerly awaiting your advise and thanking you in advance.
Dear Bill,
Your mother’s leg weakness is due to a brain tumour called meningioma which is causing compression of her motor area in her brain, together with surrounding brain swelling (oedema).
This can be removed, usually totally, with stereotactic microsurgery with about 1-2 % overall risk. In most cases surgery takes 3-4 hours, and a hospital stay of 4 days. Alternatively if found to be suitable, we can carry out stereotactic radiosurgery using a dedicated Cyberknife, if there are conditions making her unsuitable for surgery.
For information, Radiosurgery entails radiation and manages in many cases to control further tumour growth only, whereas the pressure effect of a large growth will still remain. We also need to consider delayed radiation damage which may come on only much later.
Regards
Dr. LEE Foo Chiang
MBBS, FRACS
Consultant Neurosurgeon
Sunway Medical Centre
Tel: 603-74910777 or 74919191 ext: 15519
Dear Dr.,
A 34 years old lady has cervical bone graft done but sill have neck pain withiut neurological deficit, is it advisable for her to ve cervical stem cell treatment to slow down the degeneration. She has congenital weak ligament.
Dear Miss Ngu,
We need to know the initial indication for the “bone graft”. Was there a prolapsed cervical disc causing spinal cord or nerve root compression?
Stem cell treatment for this “neck pain ” is still “off label” and at best experimental.
How was the diagnosis of congenital ligamental laxity arrived at?
Need to exclude persisting compression of Spinal thecal sac from disc-osteophyte.
Best Regards.
Dr. LEE Foo Chiang
MBBS, FRACS ( neurosurgery)
Consultant neurosurgeon.
Sunway Medical Centre
尊敬的李醫生，您好！
請問李醫生:顯微神經外科手術移除骨刺,,,,這樣ㄉ手術費用大概要多少?
Dear Chelyn, please provide your email address for a private reply. Thank you.
Sorry we could not reach your personal yahoo email after repeated attempts. Below is Dr Lee’s reply.
Dear Miss Fu,
神經外科微創手术治疗頸椎骨刺費用要看几节骨刺需要开刀，以及用interbody cage fusion 或 artificial disc replacement ( 可活动). 一般会由馬幣 Rm 30k（一节）到 Rm 60-70k（三節）
請聯絡我的醫院診所電話 603 74910777或603 74919191轉分線15519 安排會診。
謝謝。
李富强神經外科專科醫生
雙威專科醫院，馬來西亞。
Dear Dr.LEE Papa saya leher’y sering sakit dan setelah diperiksa dan dirotsen kata Dokter’y Papa saya saraf leher’y terjepit tulang..kami ad jg menggunakan pemijitan tradisional,.skrg ud agk sdikit Baikan, apakah masih bisa kambuh lgi sakit’y Dok? mesti gmn ya Dok,.Apakah mesti diopersi dan kira2 berapa ya Dok harga operasi’y..?Terimakah Dr.LEE.Sukses Selalu.
Dokter saya mau tanya tentang penyakit papa saya..leher’y sering sakit dan setelah dirotsen kata Dokter’y Papa saya saraf’y terjepit tulang..untuk sementara masih mengonsumsi obat..Dokter gmn ya,.Apa Papa saya perlu dioperasi?Terimakasih Dokter.
Dear Miss Fu
It appears your father suffers from neck, arm and shoulder pain due to a bony spur of the cervical spine compressing one or more nerve roots. Once this is confirmed on MRI scan of the cervical spine, he can benefit from microneurosurgery to remove the bony spur. This in most if not all cases, brings about immediate relief of the arm and neck pain. The operation is safe and commonly done; it takes about 2-3 hours depending on the number of levels to be operated. Patient can be allowed to walk the day after surgery and go home one day later.
Dr.LEE Foo Chiang
MBBS, FRACS( Neurosurgery)
Senior Consultant Neurosurgeon
Sunway Medical Centre
Selangor Malaysia.
Dear Mr Lee
I am currently working as a medical officer in Penang and am interested to further my career as neurusurgeon. I am kern to find out more about career pathway to be neurosurgeon and life of neurosurgeon…
please kindly provide me some info via my email. thank you
regards
Dear KB,
You may contact the website of Neurosurgery Association of Malaysia (NAM). They will be able to assist you on the Master of Surgery (Neurosurgery) training program available and application procedure. Overseas training programs are usually well structured and supervised but difficult to get in.
Good luck.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Sunway Medical Centre
Hi Dr Lee,
My father is 64 years old and there’s a tumor in his brain. Currently his left side of body is weak and he’s having difficulty in walking and standing up. This affected his left leg and hand.
From his MRI report on 6 Sept 12:
Indication: Left sided body weakness insiduos onset. CT shows right sided mass with corpus callosum involvement.
Sequences: Axial T2, T1, FLAIR, ADC, DWI/ Cor GRE, T1/Post gad 3 planes
Findings: There is an ill defined mass in the right centrum semiovale crossing midline involving the body of corpus callosum measuring approximately 2.7cmx2.5cmx2.7cm (AP x W x HT)
This mass returns high signal on T2, FLAIR low on T1 and restricted diffusion on DWI. No appreaciable enhancement post gadolinium administration.
Conclusion: Features are suggestive of high grade tumor, GBM needs to be considered. Differential diagnosis includes lymphoma.
From CT scan on 8 Sept 12:
Indication: Corpus collosum mass planned for IGS
Findings: There is an enhancing mass seen occupying the splenuim of the corpus collosum crossing over to involve the right cerebral hemisphere.
Impression: Corpus collosum lesion. Differentials include GBM or lymphoma.
I hope you can provide your professional advise on my father’s condition if an operation or biopsy is required? Could you suggest a doctor that specialises in this area? I would also like to know roughly how much does it cost for the surgery and treatment?
Please let me know if you require me to send you the full MRI/CT scan report.
Your professional advises and contributions are much appreciated. Thanks.
Dear Kym,
It would appear your dad has primary brain tumour (glioma) with transcallosal extension to the opposite side.
This can easily be confirmed by taking a small piece of tumour tissue for examination through a rather minimally invasive procedure called stereotactic frame based or frameless biopsy before further treatment is contemplated. Surgery is aimed at subtotal or radical resection and the corpus callosum and L hemisphere part is not advisable to be removed as this will result in unacceptable disabilities.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon
Dear Dr Lee,
My mum suffers from MYASTHENNIA GRAVIS about 10 years . She is often dizziness & walking imbalance.
She has seen a lot of Neurology Doctors in Ipoh, but not improved. After try the
medicines a while , the dizziness come back again. I notice & doubt that every time when doctor gave her a new type of medicine, she Psychological resist to take it.She will afraid to be after-effects, as if taken the new medicine, will harm her kidneys.
Since she did not improve for many years, because of the dizziness & recently she is so depression, she is not interested in anything, she often easily tired, like to sleep , did not like to go out at all.
We sent her to see a Psychiatrist at Ipoh, but she resisted very own depressive disease, maybe of the Psychological factor she took the pills did not felt rehabilitation.
I hope you doctor can give me your professional advice on my mum’s medical,
or can i make an appointment with you at SUNWAY MEDICAL CENTRE …
Thank you and my best regards,
Pei Li
USJ SUBANG JAYA.
Dear Miss Pei Li,
Myesthenia Gravis is handled by Neurologists with medications. You can call Sunway Medical Centre and make an appointment for your mother to see our Senior Consultant Neurologist Dr. Lee Moon Keen. Surgery is generally not needed unless there is a Thymoma in the chest as the underlying cause of her Myaesthenia.
Thank you.
Dr. LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Consultant Neurosurgeon.
Sunway Medical Centre.
Dear Dr. Lee ,
Thanks for your advice.
I would like to ask who can / how can to determine there is a “Thymoma in the chest” ?
What cause my mother dizziness & walking imbalance ?
As Dr.Lee recommended Senior Consultant Neurologist Dr. Lee Moon Keen is the right person to look for?
Thanks & regards,
Pei Li
Yes, that is correct,
Best wishes.
Hi Dr.Foo,
I am a student.
I have headaches since this year and would like to have some check-up.
What sort of check up I should do and it is expensive?
Thank you!
Dear Mr/Ms Wong,
Thank you for your e-mail.
Headaches are quite common and in most cases not of any serious nature. Most of them are treated with simple pain killer. However if the headaches are associated with other symptoms like blurring of vision, numbness/ weakness of limbs, unsteadiness etc or vomiting, more significance should be attached to the headaches. If there is increasing severity or frequency of pain this will also warrant more attention. Most of the headaches fall within the big categories of tension headaches or migraine. You can see a neurologist for
A proper neurological assessment.
Regards.
Dr LEE Foo Chiang
MBBS, FRACS (Neurosurgery)
Dear Dr. Lee,
My mum recently complained about noise in ears and massive giddiness. I took her to Damansara Specialist and did MRI scan. She was admitted for 2 days and an ENT Specialist gave 3 weeks medication. To our surprise, she still complains about the noise and massive giddiness. I was thinking of seeking second opinion.
Thank you.
Sheela
Dear Sheela, if the MRI scan was normal, this is not so likely to be a neurosurgical problem. In that case, you may need to consider seeing a neurologist. Dr Lee Foo Chiang is a neurosurgeon; if you would still wish to consult him, please feel free to contact his clinic for appointment.
Best wishes, Webmaster
Dear Dr Lee, I hope you can give your professional advice on my son’s medical concerna which developed only few days back. He is 21 yrs old and overweight (172cm, 87kg). He complaints about droopy lip on the left side, as well as his left eye’s lid having less muscle movement…. He does not have any problem with his left limbs though. His left vision is also normal. Just these 2 problems – droopy left lip and left eye’s lid, mentioned here. Should I bring him to hospital immediately for MRI or CT scan on his brain? Thanks so much in advance for your prompt advice! From an anxious father, DT.
Dear Mr Tan,
I think it is a good idea to bring your son to see a neurologist or neurosurgeon for neurological assessment on his condition. There are a few possible causes for his symptom including inflammation or compression involving the third cranial nerve. Other possible etiologies like myasthenia gravis need to be excluded. MRI/MRA brain helps to rule out structural lesions.
Thank you.
Dr. LEE Foo Chiang
Dear Dr. Lee, thanks so much for your advice. Pls advise if he needs to make appt in advance in order to see you or your colleague at your medical center.
Dear Mr Tan
Pls contact the office of Dr Lee Foo Chiang to make an appointment.
Thank you.
on behalf of Dr F C Lee.
Dear Mr Lee,
I am from Indonesia. My mum suffers Trigeminal Neurolagia. Please kindly advice what kind of medication would be suitable for her and where can we get the treatment?
Thank you.
Dear Widi,
Thank you for your e-mail.
Trigeminal Neuralgia can be treated with microsurgery if medications like Carbamazepine fail or has intolerable side effects, commonly dizziness and drowsiness. The operation is called micro vascular decompression and leads to long term or permanent cure in over 90% of cases. It is a very safe procedure with an overall risk of perhaps 1% in my view. This is an operation that I have performed in over maybe 500 cases the last 34 years of my career in neurosurgery.
Feel free to contact me or my staffs at +603 74910777 or +603 74919191 ext 15519.
Thank you.
Dr LEE Foo Chiang
Hi Doctor Lee. My name is Ethan and I am 24 years old undergraduate. I am facing symptoms like migraine, extremities numbness, neck pain, chest pain, stiff shoulder and arm pain since year 2011. Been undergo a MRI check in September 2011 which reported central disc bulge at C3/4 & mild disc bulges at C4/5 and C5/6. Signal intensity in the spinal cord is normal.
Medication prescribed by my specialist doctor were imigran, propanolol, sibelium and arcoxia. However, these medication doesn’t really work on me, except Arcoxia. However, I have been stop taking Arcoxia since November 2011.
My doctor told me that I do not require a surgery treatment, and symptoms occurs due to the narrow space movement between the cervical disc.
But due to the pain persists afterwards. I look for physical treatment such as acupuncture, massage and even chiropractor. And I have been spending thousand over Ringgit for all kind of physical treatment. However, those treatments could only help to relieve my pain and don’t seem to give much help on the overall condition.
These days, the numbness feeling around my extremities get worsen and occur quite frequently. Shoulder stiffness also exaggerating. I can’t sleep well with a pillow and thus I end up not using any. I wonder is my slipped disc problem worsen? Should I go for another MRI check though the last time I did was half year ago?
Or should I continue to take Arcoxia 120mg? Would it be any hindered side effects?
What would Dr. Lee recommend? I would appreciate if you could give some advice about it. Thank you very much! 🙂
Dear Mr Ethan,
Thanks for your e-mail.
I think you need to have the MRI Cervical Spine repeated and a proper neurological assessment done. Your symptoms appear to be due to compression of nerve roots and spinal cord by disc prolapse.
Feel free to contact my office at +603 74910777 or 603 74919191ext 15519.
Thank You.
Dr Lee Foo Chiang
Hi Dr
Thank you and appreciate your kind advice. Will do so very soon.
I have stenosis on my back lumbar #4 and #5,both legs will be numb if i walk or stand too long.
I’ve seen a few surgeon which recomended surgery.I hope that you can accomadate me for an appointment.
Looking forward to your kind reply.
Thank you
Dear Imran, your enquiry was forwarded to Dr Foo-Chiang Lee for a private reply.
Dr Lee Moon Keen (on behalf of Dr Foo-Chiang Lee).
Dr Lee FC
where can I have cell stem treatment inKL for CKD stage 3 ?
Many Thanks
Dear Gary, We are a team of specialists in the neurosciences. Regret we are not able to comment on the treatment of kidney diseases. Best wishes.
Webmaster
Hi doctor, I need ur advice. My father got epilepsy when he 18y.o(I heard from my grandma). Now he is 53y.o, he take medicine for long time already, but it stil cannot control his sickness. He always injured when he dizzy, like head broken, leg or hand injured..my family n I worry abt him all the time but v can’t stay beside him 24hours whole day long. He don’t have any transport cox he can dizzy anytime. For ur advice, if take surgery can reduce his sickness? Or maybe 100% recover? How much for surgery cost? Pls advice. Thank you.
Dear Cat Loke, Your father needs to have a thorough clinical assessment in order to decide if an operation might be helpful. You could consider a consultation with the neurologist, and subsequently the neurosurgeon, if surgery is an option.
on behalf of Dr Foo-Chiang Lee
Dear Dr. Lee,
I need your advice on the case of syringomyelia.
My boyfriend having scoliosis around 10 years ago but he actually never feel anything wrong with it. However, about 5-6 year ago, he start feel that his left arm is getting weak, and the condition is getting worse as time goes by. Now he is unable to lift up his arm over the shoulder level and even less sensitivity to hot and cold.
After he gone through MRI scan and doctor from Spinal Orthopaedic pre-diagnose that he is suffering from syringomyelia but the doctor said he need to consult doctor from Neurosurgeon. We need your advice on this syringomyelia sickness. Is it risky to do the surgery? As per what we been informed by the doctor, surgery might be the only treatment for it. Is there any other treatment which is advisable? Is the surgery is one time effort?
Besides, may i know is it exercise can help in reduce the hand weakness or it might cause the condition getting worse? What type of exercise is recommended?
Is there any other way can help in reduce the symptoms?
Dear VS, Please refer to your email for a private reply. Best regards.
Dear Dr.Lee,
As per the response, is it the Gardner’s operation will involved with the plugging of Obex?
Dear VS, We no longer plug the obex when we perform Gardner’s operation as Gardner him self noticed vagus/bulbar paresis after obex plugging.
Dr Foo-Chiang Lee
Dear Dr. Lee,
Good day. My wife is suffering from this syringomyelia as mentioned by VS. Do you mind to share the reply with me as I am also eager to know the same questions ask by VS. Thanking you in advance.
Der Wey Lim
Our neurosurgeons advise that syringomyelia should benefit from Gardner’s operation (craniovertebral junction decompression and syringostomy).
Best wishes.
Dear VS
Dr Lee Foo Chiang has indicated that Gardner’s operation (craniovertebral junction decompression and syringostomy) should be considered. This can be discussed further with a consultation if so desired.
Best wishes, Dr M K Lee
Dear Dr Lee,
Millions of thanks if you can provide me your professional advises about my current health condition, I’m helpless as this problem has been affected my life.
Please allow me to share my story which happened since last 3 months:
It’s suddenly happened to me at first week on Feb. I discovered my first symptom which is headache. I found my eye is difficult to focus and see double images on the following day. I went to a clinic to see the doctor and the doctor gave me fever and headache medicine. My problem still can’t solve after I took the medicine and I continuously when to the clinic for 6 days. At the 7th day, my condition still the same and went to the clinic again. The doctor finally wrote letter for me transfer to specialist. I desired to go the first hospital Penang Lam Wah Ee.
At this hospital, I still can walk, no dizzy and smooth speaking. The doctor just assumed I’m a normal fever and stress in work. Since this doctor unable to solved my problem, my wife ask and requested for CT Scan but unfortunately there’s no neurologist at the hospital can view the CT scan report. On the next day morning, I was attended by the same doctor again and still said I’m OK And can discharged. After 4 days staying at hospital Penang Lam Wah Ee. The doctor unable to do anything, so, i transfer to another specialist called Penang Loh Guan Lye specialist.
At Loh Guan Lye specialist, doctor advised better refer to MRI rather than CT Scan. During waiting for MRI, I fainted. I woke up at night on bed; I found that I was In HDU (High definition Unit). That night after the doctor saw my MRI Scan report, they declared my illness is called ‘Brain Abscess’. My neurosurgeon said I cannot do operation otherwise will affect my breathing. Another neurologist ask my wife to stay back because i have life threaten. Doctor gave a strong antibiotic for me. I have been injected antibiotic continuous for 2 weeks. I have been staying in that hospital for 1 month. Before I discharged, doctor requested me to Scan the MRI again. Based on my latest MRI on March, doctor said OK and allowed me to discharge.
The doctor provided me the medicine called 60 Nootrophil Tablet 1200 MG (1tablet 2times a day), 90 Dilantin Capsules 100 MG PHENYTOIN SOD (3CAPSULES once a day at night) and 60 Arcalion Tab 200 MG Sulbutiamine(1 tablet 2times a day)
Doctor said i can recover but takes time. Not sure when …..He also suggested me to wear a spectacles (no degree) with closing on one side.
As of today, I still feel dizzy and dizzy on my head, eyes can see but still unable to focus clear and see double images; can speak but not smooth; feel numbs on my face, inside my nose, inside my mouth, my tongue and also both hands, feel my left side less movement (have movement but looks abnormal and uncontrollable) I can eat, can drinks, can go toilet. I Also can walk but slow and unsteady, like A DRUNKER…
Still cannot pursue my work and my driving. Before I Walk, i have to grab or hold something (make it balance) otherwise i will easily fall down. This round really have changed my life styles..
p/s: i used one hand and one eye–right side to type this mail ..
Your professional advises and contributions are much appreciated please.
Dear Mr Leong, it looks like you have survived a potentially fatal condition. You are now at the recovery phase and need to manage the residual symptoms, which will take time to recede. The most disabling appears to be imbalance, at least some of it being due to double vision. You need to discuss with your doctors if this is permanent or not. If it is expected to improve, the most practical temporary solution is to patch the malfunctioning eye (like Sally Brown in the “Peanuts” cartoon
http://www.tompreuss.com/wp-content/uploads/2009/04/19651209_peanuts_amblyopia.png). You could also wear special spectacle lenses to correct for squint, and the longer term solution is squint surgery. Take heart and best wishes for your recovery.
Dr M K Lee
Hi Dr Lee,
I recently came across this news article regarding the Nu Vasive Nerve monitoring system and would like to know if this equipment is available at Sunway Medical Centre? I have a tumour on nerve located near L5/S1 and am very afraid to undergo surgery due to the nerves located near the spine. Knowing that this equipment actually helps in avoiding areas where nerve roots are located really delight me. Can you please provide me more information on this? Or advise whether or not Sunway Medical Centre is using similar equipment?
Thanks.
Dear SY, Nu Vasive is useful in alerting the operating surgeon while operating near nerve tissue especially when the nerve tissue or structures are not directly visible. In your case of L5S1 neuroma, the nerve is usually under direct vision of the neurosurgeon’s operating microscope and hence we find a nerve stimulator (Medtronic) will be more relevant to your case.
Thank you.
Dr LEE Foo Chiang
Dear Doctor,
My name is Mohammad Faisal from Brunei. I would like to ask for your kind favour to sort of giving me some advise with regards to my daughter’s medical problem. The following is the medical report regarding her case. We don’t have the specialist to operate on her and I am hoping if you could give some advise what kind of treatments and where to for this kind of disease, medical cost, hospitalisation, procedures and any other relevant informations. I have the MRI CD available if you do requires. Does she qualifies for Cyberknife procedure?
Dear Encik Faisal
Please refer to your email for a private response to your query. Best wishes from us.
Thank you very much for your effort and medical hospitality. We can never thank you enough for what you have done.
From the family of LIM IM NIE ( Surgery done on 24-02-2012)
Hi Dr Lee,
I am glad I found this site. My son suffered from vertigo for the past 4 months. Antibiotics did not help. He is diagnosed in the 3rd mth with vestibular neuritis. He has been taking medication and undergone rehabilitation, his condition has improved only to relapse twice in the past 2 mths of treatment. The degree of dizziness has increased in the current relapse. A brain MRI shows a frontal left arachnoid cyst of the size 15mm x 25mm x 35mm. He has been having pressing on top of his head (not pain) on and off (since the age of 6 as far as he can remember)
Just this evening, he felt pressing pain in between his neck and left shoulder. Less than 1 hr later, experienced pressing on top of head for 3 min. Later during bedtime, he had another pressing on top of head for at least 20 min. He said the pressure on top of his head feels greater when he laughed out loud compared to when he is more settled down. Last year, he had many episodes of pressing on top of his head (pressure is greater). When pressing is greater, he feels a bit dizzy. FYI, my son has got allergy nose. Had sinusitis with vertigo 2 years ago. Recovery took about 3-4 weeks. But at that time, the dizziness is not as great as now. He had missed lots of schooling due to the vertigo, as he could not see well and write. He could be having the vertigo throughout 24 hrs now.
My question: Is the pressing on top of head related to the vertigo or the arachnoid cyst? Is the Vertigo related to the arachnoid cyst? What treatment is recommended?
Dear Hopeful Mum, The pressure sensation on top of the head can be related to the moderate sized arachnoid cyst especially when there is clear exertion exacerbation. It is not related to vertigo in the strict definition of vertigo. Of course many people will use “dizziness” to describe any head discomfort.
Vertigo is more commonly due to sinusitis. Arachnoid cyst if sizable can be resected safely through micro-neurosurgery to prevent further compression of the underlying brain. Other surgical options include cysto-peritoneal Shunt or neuro-endoscopic fenestration/ drainage.
Thank you.
Dear Dr.Lee, With reference to Dr.Lee FC’s 24-Jul-2012 reply to my 29-Jan-2012 posting on this site. My son’s dizziness & the pressure on top of his head (since Sep2011) completely subsided end of May2012. Sadly, the dizziness, tinnitus and pressure on top of head returned early Sep 2012 till now (6 weeks already). Description of his current condition : When dizzy (spinning), there is pressure on top of his head with left ear pain & tinnitus. When no dizzy, no pressure on top of head. His neck also felt tight regardless of the dizzy or non-dizzy time. He said it is painful when I slightly press on his head and the back of the neck (esp. where the internal carotid artery is). The degree of dizzinesss and pressure on top of his head has since keep increasing. Besides, he started to complain of poking pain on his abdomen and in the head since 3 weeks ago. He has been having a total of about 3 to 4 hours dizzy-free time in a day for the past 1 month. For the past few days, he dizzy whole day (at the same time with the pressure on top of his head, tinnitus and ear pain). Sometimes, fluid come out from his nose, tho he is not having any nose blocked or flu. ENT doc has ruled out ear, nose and throat problem this round. FYI, he has had a turbinoplasty in Jan 2012 and his sinusitis problem is so far clear. Another doc said it is migraine. But migraine would usu. be gone after 1 day only to return. My Question : What is causing the pressure on top of his head, dizziness and stiff neck? Are the symptoms related? Are they caused by the frontal left arachnoid cyst? (you mentioned the size is moderate). Should my son go for a thorough head & body checkup. But I do not know who and what type of checkup/scan to find the root cause.
Dear Hopeful Mum
You would appreciate that it is not possible to give any sound advice without a proper assessment of your son’s physical condition and test results. Do consult his doctors for a better understanding of his symptoms as well as the treatment. Alternatively, you could consider a consultation with a neurosurgeon.
Best wishes.
Webmaster, on behalf of Dr F C Lee.
Dear Dr Lee,
I am male, 65yrs and having sciatica pain down left leg. Hot flushes in right foot. Went for L4/L5 fusion surgery in April 2000. But no improvement after surgery. Pain pattern same. Less pain in morning and start to get worst as day goes by. Cannot walk or stand too long. Tried various pain killers but no help. Only help is to take dormicium to sleep. Good sleep less pain. Now osteoarthitics detected in left hip. Wonder you can do something.
Thanks & Regds Yeo Kim Tek
Dear Mr.Yeo,
Our apologies for the delayed response. Your symptoms suggest continue nerve compression either at the neural foramen, lumbar canal stenosis or less likely, due to implant. A lot depends on what type of fusion, whether pedicle screw fixation or internist cage fusion. Further operation is more demanding due to scarring. If the compression is related to implants, the latter may need to be removed.
It is worthwhile to consult your original surgeon.
Thank You.
Dear Dr. Lee,
I am Mr. Tan, your pt. (from Kedah) who recently undergone the cerebral aneurysm clipping procedure at Sunway Medical Centre. I would like to express my greatest appreciation and thank you to Dr.Lee for whatever treatment and surgery had have done to overcome my critical condition without causing any unexpected side effects. Thank you again and for sure i will strongly recognise Dr.Lee to my friends and members of family in the future.
Regards,
Sin Keat
Padang Serai, Kedah
Dear Dr Lee,
Appreciate you can give me some clue about my mother;56,who has been diagnose with Myasthenia Gravis just 2 months ago. Her doctor have been prescribed Prednisolone 5mg and pyridostigmine 60mg. however,as a daughter ,i m very worry about her condition as her muscle is getting weaker .
Pls advise me what to do ?
Thank you and my very best regards.
Kheng
Dear Ms Kheng
I am replying on behalf of Dr Lee Foo Chiang, since myasthenia is managed by the neurologist. The medications mentioned are part of the treatments commonly used for this condition. It is best that you consult the neurologist who is taking care of your mother regarding the precise diagnosis, treatment options, and time expected for improvement.
Best wishes
Dr Lee Moon Keen FRCPE
Consultant Neurologist
My daughter is tetraplegia at level C6/7 due to TB meningitis since one year ago, no sensation and movement from waist down. I would like to check whether there is any treatment which could help her regain/improve movement eg. stem cell, etc?
Thank you.
Dear Eve
Our neurosurgeon colleagues advise that, to date, the research on stem cell treatments has not shown benefit for spinal cord damage which is caused by infections. You would have to continue with the present treatments while waiting for future developments.
Best wishes from us.
Thank You Dr. LEE FOO CHIANG for his surgery on my arm recently. My arm tumour was removed successfully and cousing no injuries at all to my whole arm. Thank You again.