A case of Pseudotumor cerebri associated with primary antiphospholipid syndrome

Abstract

Antiphospholipid syndrome is clinical manifestations have been associated with antiphospholipid antibody and hypercoagulability. Primary antiphospholipid syndrome is this condition with no underlying disease and secondary antiphospholipid syndrome is with underlying disease - SLE, malignancy. This is known to be associated with various neurologic syndromes. Stroke, headache, cognitive dysfunction are common while other manifestations such as dementia, epilepsy, chorea, multiple sclerosis, psychiatric disease, transverse myelitis, sensorineural hearing loss and movement disorders are also associated with the syndrome. But pseudotumor cerebri is a rare manifestation. Case : A 18-years-old woman complaint diplopia. Neurologic examination revealed right 6th nerve palsy. MRI findings of the patient was empty sella and ethmoid sinusitis. In laboratory findings, she had thrombocytopenia in complete blood count. Ophthalmologic test revealed bilateral papilledema and decreasing visual acuity on right eye. During evaluation of thrombocytopenia, it was showed false positive in VDRL, prolongation of activated partial thrombin time, high titers of anticardiolipin antibodies and positive reaction on lupus anticoagulant but normal titers of other auto-antibody screening test. Cerebrospinal fluid values were normal except for an opening pressure increase over 400mmH2O of fluid. The patient`s symptoms improved with repetitive lumbar puncture, the use of acetazolamide, anticoagulation, steroid medication