Date:
Patient:
Reason for Visit:
Follow-up for schwannomatosis
Assessment of new or worsening tumors
Evaluation for pain or neurological symptoms
Management plan discussion
History:
Presenting Illness:
Date of initial schwannomatosis diagnosis
Type of schwannomatosis (diffuse or localized)
Location and number of known tumors
Presence of pain, weakness, or sensory changes
Family history of schwannomatosis (if any)
Past Medical History (PMH):
Underlying medical conditions (e.g., neurofibromatosis)
Prior surgeries for tumor removal (if any)
Physical Exam:
Neurologic:
Evaluate for motor weakness, sensory loss, or reflex abnormalities depending on tumor location.
Palpation: Assess for presence of new or enlarging masses along nerves.
Diagnostic Tests (may be ordered depending on clinical presentation):
Imaging Studies:
MRI scan with contrast: The most effective imaging study to identify schwannomas (tumors) and assess their size and location relative to nerves.
CT scan (less preferred): May be used if MRI is contraindicated.
Electrodiagnostic studies (EMG/NCV) (may be indicated): Can assess nerve function and help determine if symptoms are caused by nerve compression from tumors.
Assessment:
Disease activity: Based on the presence of new tumors, worsening pain, or new neurological symptoms.
Tumor characteristics: Location, size, and impact on surrounding nerves based on imaging studies.
Neurologic function: Evaluate for any nerve dysfunction caused by tumors.
Plan:
Management approach based on severity and symptoms:
Observation: For asymptomatic tumors or slow-growing disease, monitoring with periodic exams and imaging may be sufficient.
Surgery: Surgical removal of symptomatic tumors causing pain or nerve compression is the mainstay of treatment.
Pain management: Medications and other strategies to manage pain associated with tumors or nerve involvement.
Physical therapy: May be helpful for rehabilitation after surgery or to improve function with nerve dysfunction.
Genetic counseling: May be recommended if there is a family history of schwannomatosis.
Patient education: Provide information about schwannomatosis, its chronic nature, and potential for new tumors.
Discuss treatment options, including the potential benefits and risks of surgery.
Explain the importance of regular follow-up to monitor for disease progression.
Follow-up:
Schedule for follow-up appointments based on disease activity:
More frequent visits for patients with new symptoms, rapidly growing tumors, or requiring surgery.
Less frequent visits for patients with stable disease and no concerning symptoms.
Regular imaging studies (MRI scans) to monitor for tumor growth or development of new tumors.
Monitor for pain, weakness, or other neurological symptoms that may indicate nerve compression.
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of schwannomatosis