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Pseudotumor Cerebri and Hypothyroidism

Pseudotumor Cerebri and Hypothyroidism Abstract • A 38-year-old obese woman with concurrent hypothyroidism and pseudotumor cerebri was monitored with serial thyroid function tests and CSF pressure determinations during levothyroxine sodium replacement therapy. Following normalization of the patient's thyroid status, assessed by both clinical and chemical indexes (serum thyroxine level, 1.5 to 11.0 μg/dL; serum thyrotropin level, 128 to 1.5 μU/mL), intracranial hypertension persisted for more than four months. After weight loss, acetazolamide therapy, and intermittent CSF drainage failed to produce remission, glucocorticoid therapy was associated with prompt, sustained resolution of the pseudotumor cerebri. Contrary to previous reports, this patient's clinical course suggests that thyroid hormone deficiency and pseudotumor cerebri are not causally related. (Arch Intern Med 1983;143:167-168) References 1. Moffat FL: Pseudotumor cerebri. Can J Neurol Sci 1978;5:431-436. 2. Johnston I, Paterson A: Benign intracranial hypertension: I. Diagnosis and prognosis. Brain 1974;97:289-300.Crossref 3. Johnson I, Paterson A: Benign intracranial hypertension: II. CSF pressure and circulation. Brain 1974;97:301-312.Crossref 4. Rottenberg DA, Foley KM, Posner JB: Hypothesis: The pathogenesis of pseudotumor cerebri. Med Hypotheses 1980;6:913-918.Crossref 5. Sklar F, Beyer CW, Ramanathan M, et al: Cerebrospinal fluid dynamics in patients with pseudotumor cerebri. Neurosurgery 1979;5:208-216.Crossref 6. Greer M: Benign intracranial hypertension: III. Pregnancy. Neurology 1963;13:670-672.Crossref 7. Greer M: Benign intracranial hypertension: V. Menstrual dysfunction. Neurology 1964;14:668-673.Crossref 8. Greer M: Benign intracranial hypertension: VI. Obesity. Neurology 1965;15:382-388.Crossref 9. Wilson DH, Gardner WJ: Benign intracranial hypertension with particular reference to its occurrence in fat young women. Can Med Assoc J 1966;95:102-105. 10. Thompson WO, Thompson PK, Silveus E, et al: The cerebrospinal fluid in myxedema. Arch Intern Med 1929;44:368-373.Crossref 11. Levin ME, Daughaday WH: Fatal coma due to myxedema. Am J Med 1955;18:1017-1021.Crossref 12. Nickel SN, Frame B: Neurologic manifestations of myxedema. Neurology 1958;8:511-517.Crossref 13. Prendes JL, McLean WT Jr: Pseudotumor cerebri during treatment for hypothyroidism. South Med J 1977;71:977.Crossref 14. Merritt HH: A Textbook of Neurology , ed 5. Philadelphia, Lea & Febiger, 1973, p 293. 15. Young RT, van Herle AJ, Rodbard D: Improved diagnosis and management of hyper- and hypothyroidism by timing the arterial sounds. J Clin Endocrinol Metabol 1976;42:330-340.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Pseudotumor Cerebri and Hypothyroidism

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350010179035
Publisher site
See Article on Publisher Site

Abstract

Abstract • A 38-year-old obese woman with concurrent hypothyroidism and pseudotumor cerebri was monitored with serial thyroid function tests and CSF pressure determinations during levothyroxine sodium replacement therapy. Following normalization of the patient's thyroid status, assessed by both clinical and chemical indexes (serum thyroxine level, 1.5 to 11.0 μg/dL; serum thyrotropin level, 128 to 1.5 μU/mL), intracranial hypertension persisted for more than four months. After weight loss, acetazolamide therapy, and intermittent CSF drainage failed to produce remission, glucocorticoid therapy was associated with prompt, sustained resolution of the pseudotumor cerebri. Contrary to previous reports, this patient's clinical course suggests that thyroid hormone deficiency and pseudotumor cerebri are not causally related. (Arch Intern Med 1983;143:167-168) References 1. Moffat FL: Pseudotumor cerebri. Can J Neurol Sci 1978;5:431-436. 2. Johnston I, Paterson A: Benign intracranial hypertension: I. Diagnosis and prognosis. Brain 1974;97:289-300.Crossref 3. Johnson I, Paterson A: Benign intracranial hypertension: II. CSF pressure and circulation. Brain 1974;97:301-312.Crossref 4. Rottenberg DA, Foley KM, Posner JB: Hypothesis: The pathogenesis of pseudotumor cerebri. Med Hypotheses 1980;6:913-918.Crossref 5. Sklar F, Beyer CW, Ramanathan M, et al: Cerebrospinal fluid dynamics in patients with pseudotumor cerebri. Neurosurgery 1979;5:208-216.Crossref 6. Greer M: Benign intracranial hypertension: III. Pregnancy. Neurology 1963;13:670-672.Crossref 7. Greer M: Benign intracranial hypertension: V. Menstrual dysfunction. Neurology 1964;14:668-673.Crossref 8. Greer M: Benign intracranial hypertension: VI. Obesity. Neurology 1965;15:382-388.Crossref 9. Wilson DH, Gardner WJ: Benign intracranial hypertension with particular reference to its occurrence in fat young women. Can Med Assoc J 1966;95:102-105. 10. Thompson WO, Thompson PK, Silveus E, et al: The cerebrospinal fluid in myxedema. Arch Intern Med 1929;44:368-373.Crossref 11. Levin ME, Daughaday WH: Fatal coma due to myxedema. Am J Med 1955;18:1017-1021.Crossref 12. Nickel SN, Frame B: Neurologic manifestations of myxedema. Neurology 1958;8:511-517.Crossref 13. Prendes JL, McLean WT Jr: Pseudotumor cerebri during treatment for hypothyroidism. South Med J 1977;71:977.Crossref 14. Merritt HH: A Textbook of Neurology , ed 5. Philadelphia, Lea & Febiger, 1973, p 293. 15. Young RT, van Herle AJ, Rodbard D: Improved diagnosis and management of hyper- and hypothyroidism by timing the arterial sounds. J Clin Endocrinol Metabol 1976;42:330-340.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1983

References