Pseudotumor cerebri physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Physical Examination
Physical examination of patients with pseudotumor cerebri is usually remarkable for:
HEENT
- Papilledema: Papilledema is very common in IIH patients but because of anatomic differences or early presentation of the disease it may be absent in some patients. The papilledema from IIH disease is mostly bilateral and symmetric, but in some cases unilateral and asymmetric papilledema can happen.[1] there is a relationship between the severity of papilledema and the chance of losing eye vision permanently.[2] On funduscopic evaluation we can see papilledema, macular exudates and edema, choroidal folds across the macula, choroidal neovascularization and elevation of serous retinal around the nerve head.[3]
- visual loss: Vision loss is very common in IIH patients. It happens as visual field loss then progress to visual acuity.[4][5]
- Sixth nerve palsy: The abducens nerve palsy can happen in IIH patients in unilateral or bilateral manner.[6]
- Other cranial nerve deficits: In some case report the palsy of these nerves was noted:
- Olfactory[7]
- Oculomotor[1]
- Trochlear nerve[8]
- Trigeminal nerve[1]
- Facial nerve[9]
- Auditory nerve[10]
References
- ↑ 1.0 1.1 1.2 Chari C, Rao NS (October 1991). "Benign intracranial hypertension--its unusual manifestations". Headache. 31 (9): 599–600. PMID 1774176.
- ↑ Wall M, White WN (January 1998). "Asymmetric papilledema in idiopathic intracranial hypertension: prospective interocular comparison of sensory visual function". Invest. Ophthalmol. Vis. Sci. 39 (1): 134–42. PMID 9430554.
- ↑ Acheson JF (2006). "Idiopathic intracranial hypertension and visual function". Br. Med. Bull. 79-80: 233–44. doi:10.1093/bmb/ldl019. PMID 17242038.
- ↑ Wall M, George D (February 1991). "Idiopathic intracranial hypertension. A prospective study of 50 patients". Brain. 114 ( Pt 1A): 155–80. PMID 1998880.
- ↑ Salman MS, Kirkham FJ, MacGregor DL (July 2001). "Idiopathic "benign" intracranial hypertension: case series and review". J. Child Neurol. 16 (7): 465–70. doi:10.1177/088307380101600701. PMID 11453440.
- ↑ Wall M, Kupersmith MJ, Kieburtz KD, Corbett JJ, Feldon SE, Friedman DI, Katz DM, Keltner JL, Schron EB, McDermott MP (June 2014). "The idiopathic intracranial hypertension treatment trial: clinical profile at baseline". JAMA Neurol. 71 (6): 693–701. doi:10.1001/jamaneurol.2014.133. PMC 4351808. PMID 24756302.
- ↑ Kunte H, Schmidt F, Kronenberg G, Hoffmann J, Schmidt C, Harms L, Goektas O (July 2013). "Olfactory dysfunction in patients with idiopathic intracranial hypertension". Neurology. 81 (4): 379–82. doi:10.1212/WNL.0b013e31829c5c9d. PMID 23794685.
- ↑ Soler D, Cox T, Bullock P, Calver DM, Robinson RO (January 1998). "Diagnosis and management of benign intracranial hypertension". Arch. Dis. Child. 78 (1): 89–94. PMC 1717437. PMID 9534686.
- ↑ Lessell S (1992). "Pediatric pseudotumor cerebri (idiopathic intracranial hypertension)". Surv Ophthalmol. 37 (3): 155–66. PMID 1475750.
- ↑ Rudnick E, Sismanis A (March 2005). "Pulsatile tinnitus and spontaneous cerebrospinal fluid rhinorrhea: indicators of benign intracranial hypertension syndrome". Otol. Neurotol. 26 (2): 166–8. PMID 15793399.