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Pseudotumor Cerebri
- A syndrome that is defined by:
- Papilledema occurs in over 90% of patients
- Elevated intracranial pressure with normal CSF composition
- Normal neuroimaging studies
- Normal neurologic exam
- Occurs primarily in young obese females
Clinical Features
- Most common symptom is headache.
- Other symptoms include normal or uncommonly decrease visual acuity, transient obscurations of vision, photopsias, diplopia, nausea, vomiting, pulsatile tinnitus and visual field loss secondary to optic disc swelling
- Signs:
- Bilateral optic disc edema
- May have abducens nerve palsy
Work Up
- Complete ophthalmological and neurological examinations including visual acuity, color vision, pupillary reactivity, fundus examination and visual field study of patients with papilledema
- Neuroimaging study and lumbar puncture
- Fundus photographs are also important to monitor disc swelling
Management
- Depends on visual status and whether or not the associating cause can be identified or treated
- Treatment of underlying causes
- Weight-loss program for obese patients
- Cessation of substances causing PTC, such as vitamin A, tetracycline, etc.
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