title: Neuro-Ophthalmological Manifestations after Intramuscular Medroxyprogesterone: AForme Frusteof Idiopathic Intracranial Hypertension?
abstract: We report a case of a 22-year-old female student nurse who presented to hospital with an acute neuro-ophthalmological syndrome characterized by papilledema, ataxia, ophthalmoplegia and headache after a single first time use of 150 mg medroxyprogesterone intramuscular injection. Clinical, laboratory, radiological and ophthalmological investigations were in keeping with the diagnosis of idiopathic intracranial hypertension but lumbar puncture did not show a raised cerebrospinal fluid pressure suggesting aforme frusteof this entity. Her neuro-ophthalmological clinical features responded well to acetazolamide and diagnostic/therapeutic lumbar puncture. Full recovery was achieved three months after medroxyprogesterone usage. Health care providers must be aware of this adverse drug reaction.
authors.affiliation: Department of General Medicine, San Fernando General Hospital; Department of Clinical Medical Sciences, University of the West Indies, St. Augustine.
authors.forename: Mandreker
authors.initials: M
authors.lastname: Bahall
authors.affiliation: Department of General Medicine, San Fernando General Hospital.
authors.forename: Antonio Jose
authors.initials: AJ
authors.lastname: Reyes
authors.affiliation: Neurology Unit, San Fernando Teaching Hospital, University of West Indies , San Fernando, Trinidad and Tobago.
authors.forename: Kanterpersad
authors.initials: K
authors.lastname: Ramcharan
authors.affiliation: Neurology Unit, San Fernando Teaching Hospital, University of West Indies , San Fernando, Trinidad and Tobago.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Hosein
authors.affiliation: Department of General Medicine, San Fernando General Hospital.
authors.forename: Karan
authors.initials: K
authors.lastname: Seegobin
authors.affiliation: Department of General Medicine, San Fernando General Hospital.
authors.forename: Krishni
authors.initials: K
authors.lastname: Bahall
authors.affiliation: Department of General Medicine, San Fernando General Hospital.
authors.forename: Hiranyadeva
authors.initials: H
authors.lastname: Sharma
authors.affiliation: Department of General Medicine, San Fernando General Hospital.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dhansingh
authors.affiliation: Department of General Medicine, San Fernando General Hospital.
authors.forename: Amanda
authors.initials: A
authors.lastname: Mahabir
keywords: Ataxia; forme fruste; medroxyprogesterone; modified Dandy criteria; papilledema