Pseudotumor cerebri with transient Oculomotor palsy

Abstract

Pseudotumor cerebri is a clinical syndrome characterized by raised intracranial pressure with normal ventricular size, anatomy and position. Headache, vomiting and diplopia are the most common symptoms. Signs include those of raised intracranial pressure including papilledema and absence of focal neurological signs. A secondary cause is identifiable in 50% of children; the most common predisposing conditions are otitis media, viral infection and medications. Management is mainly directed towards identifying and treating the cause and measures to reduce the raised intracranial pressure. Though it is mostly a self limited condition, optic atrophy and blindness can occur. Oculomotor nerve palsy is very rarely associated with pseudotumor cerebri. We report a unique case of pseudotumor cerebri who had left Oculomotor palsy with sparing of the pupillary fibres, which resolved following treatment with oral acetazolamide.

Pseudotumor cerebri in pediatric age: role of obesity in the management of neurological impairments

“…the pathology was not related to female gender or obesity, 13,17 and isolated oculomotor palsy was the only symptom in some cases. 18 By contrast, our series differed from those in the literature in its predominance of pubertal males, although the small size of our population precludes analysis of statistical significance. In 13 out of 15 cases, the initial resolution of papilledema was already present at fundus oculi examination 14 days after treatment.…”

The Importance of Toxoplasma Gondii Infection in Diseases Presenting With Headaches. Headaches and Aseptic Meningitis May Be Manifestations of the Jarisch-Herxheimer Reaction

“…Transient bulging fontanelle after vaccination reported in infants (Freedman et al, 2005) and other signs and symptoms (papilledema, strabismus, vomitus) precipitated by drugs (Drigo, Laverda, Casara, Battistella, & Zampieri, 1983;Mann, McLellan, & Cartlidge, 1988) or induced by fever and signs of roseola infantum (viral etiology) (Chansoria, Agrawal, Ganghoriya, & Raghu Raman, 2005;Drigo et al, 1983) may suggest that these were the triggering factors responsible for reactivation of inborn latent CT and further development of IIH or PTC.…”

Transient, unilateral, complete, oculomotor palsy in an adult patient with idiopathic intracranial hypertension

“…First, even a relatively late onset of headaches (after age 50) and signs of oculomotor nerve paresis must raise the suspicion of IIH if other etiologies have been previously excluded, such as an intracranial aneurysm or any other compressive lesion. Second, despite the "empty sella" abnormality on MRI, very often underreported by an interpreting radiologist, and if reported usually interpreted of no clinical We are aware of just a few clinical reports of IIH and oculomotor nerve involvement in the pediatric population, (18,19) and two additional patients have been reported, but age was unknown at the onset (20,21) with sparing of pupillary fibers in all described cases. There has been no single report of complete oculomotor palsy to our knowledge.…”