Pseudotumor Cerebri Syndrome (PTCS), Clinico-Radiological Profile: A Prospective Study

• Published in: Neurology India Vol. 70; no. 1; pp. 102 - 107
• Main Authors: Singh, Ranjeet, Kumar, Anand, Singh, Varun, Pathak, Abhishek, Chaurasia, Rameshwar, Mishra, Vijaya, Joshi, Deepika
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.01.2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Cerebrospinal Fluid Pressure; Diagnosis; Humans; Intracranial hypertension; Obesity - complications; Prospective Studies; Pseudotumor Cerebri - diagnostic imaging; Radiography; India; papilledema; secondary PTCSKey Message:The newer diagnostic criteria are invaluable in diagnosing PTCS even in absence of papilloedema. Secondary PTCS was common in our series of patients. Early recognition of secondary causes like APLAS can help prevent devastating sequalae; Idiopathic intracranial hypertension; pseudotumor cerebri syndrome; secondary PTCS
• ISSN: 0028-3886; 1998-4022
• DOI: 10.4103/0028-3886.336327

Objectives: The aim of the study was to classify patients of Pseudotumor Cerebri Syndrome (PTCS) on the basis of newer classification along with its clinico-radiological correlations. Patients and Methods: A prospective study was conducted at a tertiary care teaching hospital. A total of 25 consecutive patients who fulfilled the new diagnostic criteria for PTCS were enrolled after taking informed written consent. A thorough clinical history, neurological examination and neuroimaging was carried out. Patients were classified into Primary and Secondary PTCS followed by Definite, Probable and Suggested as per new nomenclature. Results: Out of 25 patients, there were 9 patients in the primary PTCS group and 16 in the secondary PTCS group. Mean duration of symptoms was 40.84 ± 45.68 days. Primary PTCS group patients were significantly overweight and had higher BMI as compared to the secondary group with significant number of patients reporting recent rapid weight gain. The CSF pressure and protein were non-significantly higher in the primary PTCS group. We could classify 17 (68%) patients in our study as definite PTCS, 7 (28%) as probable PTCS and suggested PTCS in one patient. In secondary PTCS group there were 16 (64%) patients. APLA positivity was found to be the most common etiology for secondary PTCS with statistical significance (P = 0.025). Conclusions: Early recognition along with appropriate classification and prompt treatment can prevent vision loss in PTCS. Apart from obesity, recent weight gain is also closely related with primary PTCS.