[Unexplained bilateral optic disk edema. So-called idiopathic intracranial hypertension of drug origin should be suspected].
In 2 clinical cases of bilateral optic disk oedema, the optic disk oedema was part of a so-called benign, or rather idiopathic, intracranial hypertension. Aetiological investigations were unable to detect any intracranial or systemic anomaly, except the fact that both patients had been on a long-term treatment. The first, a 35-year-old man, was taking Roaccutane (isotretinoin) for acne, for at least 5 years, Supradyne (containing vitamin A) minimum 1 pill per day. The second patient, aged 16 years, had also been treated for acne with Roaccutane and Mynocine (minocyclin) for several months. Minocyclin and vitamin A, contained in these substances, are likely to have induced the idiopathic intracranial hypertension, and consequently the optic disk oedema. Indeed, discontinuing the treatment and rachicentesis led to a significant resolution of symptoms. A good history of the clinical cases thus remains a key-element in the process of diagnosis-making and should be strictly conducted in cases with bilateral optic disk oedema, particularly when seen in young patients.
Benrabah
R
R
Service de Médecine interne, Centre Hospitalier National des Quinze-Vingts, Paris.
Lumbroso
L
L
Limon
S
S
Hamard
H
H
Morin
Y
Y
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010211:Papilledema / Q000209:etiology* / Q000628:therapy; D011559:Pseudotumor Cerebri / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D014801:Vitamin A / Q000009:adverse effects
D014801:Vitamin A
Oedème papillaire bilatéral inexpliqué. Penser à l'hypertension intracrânienne dite idiopathique d'origine médicamenteuse.