DR. LAKSHMI SOUNDARYA VARSHA MALLAPRAGADA

DR. RAMAN YENUGANDULA

Abstract

33y obese, HTN, diabetic lady presented with sudden onset binocular diplopia & headache since 15 days.

Examination(BE): UCVA 6/6; Anterior Segment normal;Fundus Grade 2 Papilloedema.EOM full&free.HCRT RE 15degrees eso for near&distance.Alternate cover test: (BE)Fast redressal.PBCT BE 30PD Base Out prism for near&distance. W4DT&diplopia charting:uncrossed horizontal diplopia

Investigations:Altered lipid profile.Borderline PT.Normal aPTT. MRI Brain with contrast:Partial empty sella with no space occupying lesion/granulomatous changes in parenchyma. MRV:Partially hypoplastic left transverse&sigmoid sinus.

Patient was advised weight reduction& started on Tab. Acetazolamide 500mg TID x 2wks. Symptoms,signs & esodeviation improved.

Unless there is a clearly identified etiology, neuroimaging must be done in all cases of AACE even without neurological signs or symptoms.IIH is a diagnosis of exclusion.This case shows efficacy of Acetazolamide in treatment of IIH and reduction of esodeviation.