Prednisone for PTC

[kim4]

I am a 43 year old female diagnosed with Pseudotumor Cerebri in Nov. 2002.  MRI was normal except for lacunar infarct in midbrain and spinal tap pressures were borderline 180.  Symptoms:  headache (worse in am, bending over, physical activity), nausea, dizziness, visual disturbances, neck pain, shoulder/arm pain, back pain, memory problems, awkward coordination, falling, muscle weakness, fatigue, whooshing or heart beat sounds, bilateral papilledema.  Tried Diamox and HCTZ and felt better but could not take due to a severe sulfa allergy.  Neurologist told me to lose weight and exercise and symptoms would go away-that was all he could suggest.  Have gone from size 16 to 9/10 and do 3 miles a day on elliptical trainer, but symptoms were no better until regular MD put me on Prednisone for allergies and symptoms almost disappearred but returned when prednisone discontinued (this has been done 3 times-each time symptoms returned).  MD says prednisone too dangerous to take very often.  (He has put me on 15 day taper-feel great on 40 mg a day). When my smptoms are at the worst, I spend 3-4 days a week in bed and have been unable to work for 2 years (without benefits), and must take darvocette and nausea medicine.  My question is:  If the prednisone makes my symptoms improve and almost disappear and I can function daily, and I am willing to take the health risks, why can't my doctor prescribe it for me when I need it or is there another medicine or treatment I can try.  I have drug allergies to: sulfa, penicillin, cipro, cephalosporin, aspirin, nsaid's  PLEASE HELP!!

[CCF-Neuro-M.D.-JT]

Prednisone is an accepted treatment for pseudotumor cerebrii, but usually doctors are reluctant to give it to patients who are overweight due to the potential side effect of further weight gain, which is thought to be associated with pseudotumor - thus potentiating a vicious cycle. However, since you are:
1. unable to tolerate the first line or more traditional meds 2. you're obviously making great efforts to lose weight and get in shape
3. getting symptomatic relief with the medication

then prednisone seems to be the optimal medication for you.
Now keep in mind I have never seen you personally and cannot make any accurate clinical diagnoses or treatment plans without doing so. Also, longterm prednisone does have other side effects such as bruising, osteoporosis, diabetes, and electrolye disturbances just to name a few. Talk to your doctor again or discuss this with your neurologist. I can understand how you may be frustrated as prednisone seems to be helping you, but I'm sure your doctors just have your best interests at heart. Perhaps you can work out a short term treatment plan with steroids.Good luck.

[MEKO60865]

A related discussion, OP was started.