AM Report 10/12/2016 – Lympocytic Pleocytosis and IIH

Remember that there are different grades for Papilledema on the Frisen Scale – from 0 (none) to 5 (severe)

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Remember the typical patient with IIH – female, obese, child-bearing age

Symptoms: headache (worse with valsalva / bending over), nausea (30%), visual loss (30-60%); diplopia (30%), neck stiffness, tinnitus, ataxia, dizziness

Signs: papilledema (100%), 6th nerve palsy (~10-20%) “false localizing sign”

Diagnosis of IIH:

  1. CSF opening pressure > 20 cm H20
  2. Normal CSF composition (possible exception of low protein)
  3. Signs / Symptoms of elevated ICP
  4. Normal radiographic imaging with exception of slit ventricles and/or empty sella

Be able to interpret CSF studies:

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Remember that there is broad differential for lymphocytic pleocytosis of CSF fluid.

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