Schwannoma tumours are tumours that originate inside the nerve sheath. Unlike neurofibromas that originate from cells in the sheath itself, schwannomas arise from the Schwann cells of the individual nerve fibres that the sheath contains. Schwannomas also go by the name neurilemoma. They can grow on any nerve in the nervous system, from the brain to the feet. Most often, schwannomas grow in the head, trunk and in the extremities where they flex. Schwannomas are almost always benign tumours, although they have in some cases become malignant.
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Schwannomas are usually identified only through surgical removal. While magnetic resonance imaging (MRI) scans are the best at defining the borders and size of a tumour within a nerve, it is rare to be able to differentiate between a neurofibroma and a schwannoma from the images.
Schwannomas are extremely slow-growing tumours. It usually takes years before they cause any symptoms, and they build so gradually that schwannomas are large by the time a doctor gets involved.
Schwannomas can cause a variety of symptoms. Smaller schwannomas may cause numbness, tingling, pins-and-needles sensations and electric-shock feelings. As they grow, they are more likely to cause pain and progressive numbness. The symptoms of nerve dysfunction, such as pins-and-needles, electric-shock sensations and tingling get worse as the tumour grows.
A neurosurgeon determines the treatment for schwannomason on a case-by-case basis. If the schwannoma is small and asymptomatic, doctors may recommend regular scanning and periodic check-ups to keep an eye on it. Surgery to remove the schwannoma is necessary if the symptoms of the tumour are interfering with quality of life, if the tumour is growing rapidly or if there are signs of malignancy.
Surgery for schwannomas involves manipulation of the nerve. Therefore, there are additional risks beyond the typical issues that surgery carries. Nerve manipulation can permanently damage the nerve and can even cause paralysis or total numbness. Normal side effects of nerve surgery include temporary numbness, tingling and pins-and-needles or electric-shock sensations. These can last anywhere from a few weeks to a year or more. Schwannomatosis and von Recklinghausen's disease (neurofibromatosis) are both disorders that cause schwannomas to grow throughout the body. Most schwannomas are randomly occurring, but if a doctor suspects that more tumours exist, he may order more scans to check for additional tumours.
While the risk of schwannomas becoming malignant is extremely low, it is a possibility. Schwannomas that are not causing symptoms still need periodic checking, and any new symptoms or other problems are signs of a problem. Often, the neurosurgeon cannot remove all pieces of the schwannoma, and there is a small chance it will regrow. Report any of these issues to a doctor as they arise.
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