UNEXPLAINED BILATERAL OPTIC DISK EDEMA - SO CALLED IDIOPATHIC, DRUG INDUCED, INTRACRANIAL HYPERTENSION MUST BE EVOQUED

In 2 clinical cases of bilateral optic disk oedema, the optic disk oed ema was part of a so-called benign, or rather idiopathic, intracranial hypertension. Aetiological inverstigations were unable to detect any intracranial or systemic anomaly, except the fact that both patients h ad been on a long-term treatment. The first, a 35-year-old man, was ta king Roaccutane(R) (isotretinoin) for acne, for at least 5 years, Supr adyne(R) (containing vitamin A) minimum 1 pill per day. The second pat ient, aged 16 years, had also been treated for acne with Roaccutane(R) and Mynocine(R) (minocyclin) for several months. Minocyclin and vitam in A, contained in these substances, are likely to have induced the id iopathic intracranial hypertension and consequently the optic dik oede ma. Indeed, discontinuing the treatment and rachicentesis led 20 a sig nificant resolution of symptoms. A good history of the clinical cases thus remains a key-element in the process of diagnosis-making and shou ld be strictly conducted in cases with bilateral optic disk oedema, pa rticularly when seen in young patients.