papalidema

[RosieDe]

What is papalidema, causes, treatments, etc.  (not sure of spelling...)

[Michael J Kutryb, MD]

True papilledema is swelling of the optic nerve head -generally caused by increased pressure on the brain (intracranial pressure.)   Possible causes include pseudotumor cerebri (idiopathic intracranial hypertension), brain or spinal chord tumor, closed head injury, enephalitis, meningitis, or other central nervous system diseases and disorders.  You can look up more information on this site or on google.  The first thing is to find out if it is truly papilledema and get MRI right away to rule out a serious cause.  If MRI is normal, then pseudotumor cerebri is one possible cause and would require a spinal tap for a diagnosis.

MJK-MD

[LifesAHeadache]

But can you have intracranial pressure causing SEVERE unequal pupil size and severe headache that react normally to light BUT not have signs of papilledema.

Also, if papilledema is present I thought a LP could be dangerous for the pressure issue.  And if papilledema looks mild, could you treat with DIAMOX as a diagnosis tool instead of LP.  I appreciate it if you have time to answer this.

[Michael J Kutryb, MD]

Possibly.
MRI or CT would always be done before any LP to look for any mass effect and signs of major intracranial pressure problems.
Diamox is sometimes used for the presumptive diagnosis of pseudotumor cerebri (after a major workup including MRI, blood tests, eye tests, and often LP, but I'm not sure what true diagnostic value Diamoxt has.

MJK MD