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The Journal of the American Board of Family Practice, Vol 15, Issue 3 229-233, Copyright © 2002 by American Board of Family Practice


ARTICLES

Pseudotumor cerebri secondary to minocycline intake

E. R. Ang, J. C. Zimmerman and E. Malkin
St Francis Hospital of Evanston Family Practice Residency Program, Ill, USA.

BACKGROUND: Pseudotumor cerebri, or idiopathic intracranial hypertension, is a condition most commonly affecting women of childbearing age who are obese or who have experienced recent weight gain. Frequently the patient complains of headache accompanied by dizziness, nausea, or visual defects, and it is characterized by elevated intracranial pressure in the absence of a space-occupying lesion or infection METHODS: A patient had been prescribed minocycline and subsequently developed symptoms 6 weeks after an increase in the original dosage. She was initially examined by an ophthalmologist, then was sent to the Emergency Department, and finally admitted under the family practice service. Articles were searched through MEDLINE, MD Consult, and Google. Key words included "pseudotumor cerebri," benign intracranial hypertension," idiopathic intracranial hypertension," and "minocycline." RESULTS AND CONCLUSION: Although the pathogenesis of pseudotumor cerebri is not completely understood, an association has been observed with minocycline use. This report describes a 16-year-old girl who developed idiopathic intracranial hypertension while taking minocycline for acne. Symptoms of blurred vision and severe headache unrelated to position or activity; an absence of fever, bilateral disk edema, and focalizing neurologic signs; negative neuroradiographic findings; increased cerebrospinal fluid pressure with a normal cell count; and exclusion of systemic or structural cause of increased intracranial pressure satisfy the criteria for the diagnosis of idiopathic intracranial hypertension. Minocycline is often used by family physicians for the treatment of acne, and this complication requires vigilance to protect against potential vision loss.


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D. I. Friedman, L. K. Gordon, R. A. Egan, D. M. Jacobson, H. Pomeranz, A. R. Harrison, and Y. Goldhammer
Doxycycline and intracranial hypertension
Neurology, June 22, 2004; 62(12): 2297 - 2299.
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