Cognitive impairment in patients with Pseudotumor Cerebri Syndrome

• Published in: Behavioural neurology Vol. 24; no. 2; pp. 143 - 148
• Main Authors: Kharkar, Siddharth, Hernandez, Robert, Batra, Sachin, Metellus, Philippe, Hillis, Argye, Williams, Michael A, Rigamonti, Daniele
• Format: Journal Article
• Language: English
• Published: IOS Press 01.01.2011; Hindawi Limited
• ISSN: 0953-4180; 1875-8584
• DOI: 10.3233/BEN-2011-0325

INTRODUCTIONPatients with Pseudotumor Cerebri Syndrome (PTCS) may complain of difficulty in thinking or concentrating; however there has been little formal cognitive evaluation in this population. OBJECTIVETo evaluate the characteristics and nature of cognitive impairment in patients with PTCS. METHODSWe retrospectively reviewed records of 10 patients diagnosed with PTCS who were cognitively tested at presentation. In each cognitive test, "Borderline deficit" (BD) was defined as a score more than 1 standard deviation (SD) below and "Definite Deficit" (DD) as a score more than 2 SD below the mean for age, sex and education. In each cognitive domain, impairment was defined as a single test score more than 2 SD below the mean, or scores of more than 1 SD below the mean for age, sex and education in > 50% of tests. RESULTSMean age of patients was 43.4 ± 13.5 years. 8/10(80%) patients were female. 3/10(30%) had papilledema; 3/10(30%) had significant cerebral venous outflow obstruction. Impairment was most commonly seen and was most severe in the WMS logical memory I (BD-44%, DD-44%), WMS logical memory II (BD-37.5%, DD-50%), RAVLT delayed recall (BD-30%, DD-40%) and RAVLT retention(BD-40%, DD-30%) tests. Evaluation of cognitive domains revealed impairment in memory and learning (80%), executive function (10%), visuo-spatial skills (30%), and language (30%). CONCLUSIONOur results indicate that patients with PTCS can have significant cognitive impairment, particularly in learning and memory. The prevalence needs to be studied in a larger cohort. The relationship of cognitive impairment with chronically elevated intracranial pressures and its role in contributing to patient morbidity needs to be investigated further.