Re: pseudotumor cerebri

Posted By CCF NeuroMD *!* on November 11, 1997 at 14:21:26:

In Reply to: pseudotumor cerebri posted by Alicia on November 10, 1997 at 23:05:01:







:   My 10 year old daughter was diagnosed with pseudotumor cerebri last spring. This was found after visits to a neurologist and pediatric opthamologist.An MRI was negative and papilledema was evidenced. A spinal tap was performed..her opening pressure was 260. The pressure was brought down to 140 and within a few hours she began to get relief from her constant headache,dizziness and visual disturbances.She has remained symptom free until now. The symptoms have once again reared their ugly heads! She is trying a course of Diamox instead of undergoing another spinal tap now. My questions to you are...Is it likely the pressure on the optic disk will cause permanent damage to her eyes? Are there other problems that could arise from this condition other than the effects it is having on her eyes? With the 1-2 week time span that it takes for the Diamox to "kick in" I wonder if the spinal tap is the better of two evils?
(Of course it's not MY back!)
Thank you for any information you can provide.
Pseudotumor cerebri or benign intracranial hypertension to use its other name is treated by means of a variety of options. The first line which you have already experienced is a therapeutic spinal tap which drains off the fluid giving rapid relief, the problem of course is that this does not relieve the underlying problem so that symptoms recur as the fluid re-accumulates. Your doctor has now moved on to the next line of therapy - reducing the production of  spinal fluid using Diamox, whether or not you are prepared to wait for the effect really depends on how severe the symptoms are and whether they are severe enough to put a 10 year old through a spinal tap.
In reference to your question as to the long term effects of  this condition , if untreated over a prolonged period - months to years it can cause damage to the optic nerve because of  constant pressure on the nerve, this however would not be a factor over the next couple of weeks while you are waiting for the diamox to take effect.
As regards more definitive therapy, if the condition does not respond to Diamox it is possible to place a shunt in the lower spine which allows  continuous drainage to take place, reducing pressure without drugs or repetitive spinal taps.