Big things, SMAll things

This blog post will mostly be talking about the Supplementary Motor Area (SMA). So after seeing the surgeons this week they told me my SMA has been invaded and will need to be removed.

So basically the plan is to have a large resection of most of the tumour again, anterior, posterior and superior portions of the growth that has is occurred in the last three years. However three years ago they cut out tumour that hadn't as yet invaded important areas of the brain, (those bits were left in). this time however, they are planning on resecting the SMA because it has been invaded in its entirety now. I knew something had happened because of how useless my left hand is a lot of the time. So in the consultation i was told that i would leave surgery with a deficit in my left side. the extent of which was unpredictable, varying from lack of control and clumsiness of the left side to the complete inability to use that side. however this effect should be temporary.

Post Operative Supplementary Motor Area Syndrome: clinical features and outcome. Insights from the supplementary motor area syndrome in balancing movement initiation and inhibition.

The study looks at 6 patients who underwent SMA resections due to tumours. three in the dominant side, three in the non dominant side. all patients had a reduction in spontaneous movements and difficulty in performing voluntary motor acts on the contralateral limbs. the function of these limbs in serial automatic motor activities (dressing and walking etc) was relatively unaffected however. recovery was a few weeks and five of the patients were fully recovered within 24 months. (Bunnur and Rajshekhar 2000).

Insights from the supplementary motor area syndrome in balancing movement initiation and inhibition

SMA syndrome is a characteristic neurosurgical sundrome that occurs after unilateral resection of the SMA, clinical symptoms vary from none to global akinesia (loss of voluntary movement) with global akinesia being the classic presentation. these symptoms normally resolve in weeks to months, leaving only  a disturbance in alternating bimanual movements (i think this means using both limbs at the same time). (Potgieser et al. 2014)

So basically my brain will have to adapt to create a new area to perform the actions that my right SMA currently performs. i have read that the contralateral SMA usually attempts to do this. i suppose the length of time it takes for your brain to reorganise itself is the length of time it takes for you to get back to normal. i am just hoping this syndrome is the only after effect i will be dealing with. it'll be easier to overcome one complication at a time. the loss of independence i will experience will be bad enough with out other complications making it harder.

surgery date is 3rd/4th may


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