empty sella syndrome

[valeen]

Hi
I have just had an mri after a small car accident that has left me with vertigo symtoms but it showed that I have empty sella syndrome.the doctor told me this may have happened years ago (28) when I had my children but I am not sure of that only that I have suffered with many other things that could be related.I have had fluid and urine problems for years,my adrenal glands gave me trouble after my last surgery ,thyroid nodules had been detected,many cysts on ovaries and other places,as well other things.I am now having some vision problems over the last two years which I though was due to my diabetes but am now ondering about this as they have checked my eyes.But this was before they found the empty sella and was wondering if this could be why my eyes get foggy only some of the time and not other times and should I asked to see a specialist as my doctor does not know too much he told me when I saw him last week.My hormone blood an urine test have not come back yet but I have a feeling it will show my hormnes are okay even though I have all these symtoms going on for many years now.Oh and one other thing is my heat problem it is like a hot flash but never goes away and I do not have a fever it will just make it feel like I am burning up inside and stick around for days or weeks then go away again.When I touch my husbands arm he will say your burning up again and they checked my female hormes and said they are okay also.thanks fro you help.

[Dr Rajgopal]

Hi,
Your symptoms are due to hypopituitarism related to  Empty sella syndrome
Because the pituitary gland stimulates other glands, a deficiency in pituitary hormones often reduces the amount of hormones those other glands produce. Therefore, a doctor considers the possibility of pituitary malfunction when investigating a deficiency in another gland, such as the thyroid or adrenal gland. When symptoms suggest that several glands are underactive, a doctor may suspect hypopituitarism or a polyglandular deficiency syndrome. Vision problems and hot flashes are associated with Empty Sella syndrome . In most cases, however, the pituitary functions normally as evidenced by normal thyroid functions, normal tests of adrenal function, normal somatomedin-C levels, and regular menses. Some patients have empty sella syndrome as a result of other processes such as neurosarcoidosis pituitary tumors that have degenerated, etc. Rare patients have a congenital empty sella and a coexisting pituitary tumor. Please discuss the treatment with a neurologist . Hope this helps you . Take care and regards !

[selmaS]

Empty sella has been associated with pseudotumor cerebri, hypopituitarism, visual field defects, and headache.

1) Headache is the most common symptom.  Some 70% of patients complain about pain. Pulsations of CSF against the dura of the sella could be responsible.

2) Visual alterations may be due to traction on the chiasm or involvement of chiasmal blood vessels.  Incidence is about 20% in primary empty sella syndrome.  In secondary empty sella syndrome the incidence is much higher because of the underlying sellar pathology.  Clinically the patients complain about clouding of vision, color vision defects, photophobia, and various visual field defects (bitemporal hemi-, or quadrantanopia, generalized filed constriction, quadrine constriction, central scotoma, homonymous hemiachromatopsia mimicking the lesion in patients with a suprasellar pituitary tumour.  On fundoscopy changes to the retina and papilledema can be observed.  The symptoms sometimes resemble a low pressure glaucoma thus necessitating detailed ophthalmologic examination with particular attention being paid to intraocular pressure and optic disc appearance.