Her physical examination is unremarkable. Mild cognitive impairment, bilateral grade II nystagmus and mild right hemiparesis. The deep tendon reflexes are more brisk on the right. Finger too nose test is abnormally bilateral more on the right. Heel to shin is also abnormal on the right.
Sensory examination is normal.
Lab findings including blood count, glucose, electrolytes, renal and hepatic functions are within normal limits. EEG shows a background of diffuse bilateral slowing with focal epileptic activity from the left frontal-temporal region and independently in the right frontal area, with secondary generalization. MRI of the brain in 1992 revealed an enlarged 4 ventricle with cerebellar atrophy more on the right with no evidence of reoccurrence of the tumor. An abnormal T2 weighted signal was seen close to the 4 ventricle and lateral ventricles possibly due to hemosiderin. There was no change from previous MRI's At present the patient is treated with carbamazapine 1100mg and lamotrigin 200mg daily.