tetracycline and Papilledema

Fraternal twin sisters developed idiopathic intracranial hypertension (IIH) shortly after beginning tetracycline for treatment of acne. We reviewed from the literature 19 familial cases of IIH and 37 cases of IIH associated with tetracycline usage. Among the 37 combined adult and pediatric cases, 26 of 37 had resolution of signs or symptoms of IIH within hours to days of stopping the antibiotic, and rapid recurrence with reinitiation of drug occurred in 4 of 37. We suggest that these cases may be tetracycline-induced, may be related to an underlying genetic susceptibility, and support the notion of multifactorial etiologies for IIH.

Topics: Acne Vulgaris; Adult; Child; Diseases in Twins; Female; Humans; Papilledema; Pseudotumor Cerebri; Tetracycline; Twins, Dizygotic

Topics: Adult; Aged; Angiography; Animals; Blood Circulation; Brain Neoplasms; Carcinogens; Cats; Chloroquine; Choroiditis; Dogs; Eye Diseases; Female; Fluorescence; Glioma; Haplorhini; Hemorrhage; Humans; Mestranol; Microscopy, Electron; Neuritis; Norethynodrel; Optic Nerve; Oxygen Consumption; Papilledema; Polyarteritis Nodosa; Rabbits; Retina; Retinal Detachment; Retinal Vessels; Tetracycline

Topics: Adolescent; Brain Diseases; Brain Neoplasms; Cerebrovascular Circulation; Child; Diagnosis, Differential; Electroencephalography; Endocrine System Diseases; Female; Hematologic Diseases; Humans; Infant; Male; Obesity; Papilledema; Prognosis; Pseudotumor Cerebri; Tetracycline; Vitamin A; Vitamin A Deficiency

A young, non-obese woman aged 24 years with normal blood pressure developed intracranial hypertension after the oral use of tetracycline. Neuro-ophthalmologic examination revealed severely reduced acuity, papilledema, and concentric impaired visual fields. She was treated with acetazolamide and recurrent lumbar punctures and recovered, but without improvement in either acuity or visual fields. Intracranial hypertension is a fairly rare disease characterised by increased intracranial pressure without structural abnormalities in the brain or hydrocephalus, and is termed idiopathic in the absence of an underlying cause. Tetracycline should be considered as a cause of intracranial hypertension if a patient complains of previously unknown headache a few days after its ingestion. Headache and the presence of bilateral papilledema, decreased visual acuity and visual-field defects are indications for urgent referral to a neurologist. Therapy consists of a combination of repetitive lumbar punctures and medication. Surgical interventions include lumboperitoneal shunting and optic nerve fenestration. Intracranial hypertension may lead to irreversible decreased visual acuity and visual-field defects resulting in disability.

Topics: Acetazolamide; Administration, Oral; Adult; Diuretics; Female; Humans; Intracranial Hypertension; Intracranial Pressure; Papilledema; Recurrence; Spinal Puncture; Tetracycline; Treatment Outcome; Visual Acuity; Visual Fields

Idiopathic intracranial hypertension (IIH, pseudotumor cerebri) was diagnosed in 4 patients who had been treated with tetracycline. The main symptom was headache, and in all there was papilledema. Symptoms and signs improved after tetracycline was discontinued and acetazolamide treatment started. When a patient receiving tetracycline develops IIH, the medication should be stopped as it may be the cause of the IIH, as appeared to be the case in our 4 patients.

Topics: Acetazolamide; Adolescent; Adult; Female; Headache; Humans; Male; Papilledema; Pseudotumor Cerebri; Tetracycline

The incidence of Lyme disease has been increasing at alarming rates in recent years. Being the most commonly reported tickborne bacterial disease in the United States, it now outnumbers Rocky Mountain spotted fever by a ratio of almost 2:1. It is a multisystem illness and can manifest itself with dermatologic, neurologic, cardiac and rheumatologic involvement. The ocular complications of Lyme disease can present as one of the more ominous signs during the course of the illness. The detection of the disease and proper referral by the optometrist may permit more appropriate treatment, and thus, a better prognosis of the illness.

Topics: Bites and Stings; Borrelia Infections; Conjunctivitis; Eye Diseases; Humans; Keratitis; Lyme Disease; Optic Nerve Diseases; Papilledema; Penicillins; Tetracycline; Uveitis

A female adolescent on tetracycline therapy for a dermatologic condition developed pseudotumor cerebri resulting in impaired visual acuity and papilledema. The therapy of pseudotumor cerebri is discussed.

Topics: Acne Vulgaris; Adolescent; Dexamethasone; Female; Humans; Papilledema; Pseudotumor Cerebri; Tetracycline; Vision Disorders

Benign intracranial hypertension occurred in four young women taking tetracycline for acne; two were also taking vitamin A. In a fifth case a 14-year-old boy developed papilloedema after taking a short course of tetracycline for bronchitis. All symptoms disappeared soon after stopping the drugs, though in two cases the papilloedema persisted for many months. Benign intracranial hypertension should be sought in any young woman complaining of headache during treatment with tetracycline. Moreover, young women given vitamin A and tetracycline in combination for acne may be at special risk and should be kept under surveillance.

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Male; Papilledema; Pseudotumor Cerebri; Sex Factors; Tetracycline

Topics: Adolescent; Brain; Brain Diseases; Brain Edema; Cerebral Hemorrhage; Child; Craniocerebral Trauma; Diagnosis, Differential; Encephalitis; Encephalocele; Humans; Hydrocephalus; Infant; Intracranial Pressure; Meningitis; Papilledema; Pseudotumor Cerebri; Spinal Puncture; Tetracycline; Tomography, X-Ray Computed; Vitamin A

Benign intracranial hypertension due to tetracycline is described in an adolescent female. Complete resolution of the condition occurred when the drug was withdrawn.

Topics: Adolescent; Female; Humans; Papilledema; Pseudotumor Cerebri; Tetracycline

Three consecutive cases of Whipple's disease observed by us in recent years have involved neurologic symptoms, i.e. psychoorganic syndromes, gaze palsy, nystagmus, masseteric and pharyngeal myoclonus or papilledema. In one case mononuclear cells in the cerebrospinal fluid, most probably of ependymal origin, were loaded with periodic-acid-Schiff (PAS) positive granules. On treatment with antibiotics the neurologic signs cleared considerably or completely. The findings suggest (a) that neurologic involvement Whipple's disease may not be so uncommon as appears from the literature, (b) that examination of the spinal fluid with PAS staining may be helpful in the diagnosis of such cases, and (c) that neurologic involvement in Whipple's disease may also be amenable to treatment with antibiotics.

Topics: Adult; Aged; Cerebrospinal Fluid; Chloramphenicol; Cognition Disorders; Eye Manifestations; Humans; Male; Masticatory Muscles; Myoclonus; Neurologic Manifestations; Papilledema; Penicillins; Streptomycin; Tetracycline; Whipple Disease

Topics: Adult; Biopsy; Female; Humans; Papilledema; Radiography; Tetracycline; Whipple Disease

Topics: Ampicillin; Headache; Humans; Intracranial Pressure; Male; Middle Aged; Papilledema; Tetracycline

Topics: Acne Vulgaris; Adolescent; Brain Diseases; Female; Humans; Intracranial Pressure; Papilledema; Pseudotumor Cerebri; Remission, Spontaneous; Tetracycline

Topics: Anorexia Nervosa; Brain Diseases; Child; Diagnosis, Differential; Headache; Humans; Male; Papilledema; Pseudotumor Cerebri; Tetracycline; Time Factors; Vomiting

Topics: Adult; Headache; Humans; Hypertension; Intracranial Pressure; Male; Papilledema; Tetracycline; Vision Disorders