PSEUDOTUMOR CEREBRI (TOXIC EFFECT OF THE MAGIC BULLET)

A 10 year-old female patient presented to the outpatient unit of the o phthalmology department of Menelik II Hospital with complaints of inwa rd deviation of the left eye, of three weeks' duration. The patient wa s on a mega dose of vitamin A 200,000 I.U. (the ''magic bullet'') dail y for two months prior to the onset of the present illness. Physical e xamination revealed left sixth nerve palsy and bilateral papilloedema in an alert and oriented patient without localizing neurologic finding s. The cerebrospinal fluid pressure (>250 mm water) was increased and skull X-ray findings were suggestive of increased intracranial pressur e (IIP). This case meets the modified Dandy criteria except that a hig hly likely cause, hypervitaminosis A, is associated. Therefore, a diag nosis of Idiopathic Intracranial Hypertension (IIH) or Pseudotumor Cer ebri was made. This disorder and its management is discussed and liter ature reviewed. The serious and potentially blinding: toxic effect of vitamin A, if consumed in excessive amounts, is emphasized.