Benign intracranial hypertension after antibiotic therapy.

Benign intracranial hypertension or pseudotumour cerebri is a syndrome of increased intracranical pressure and bilateral papilloedema in a patient with normal or small ventricular systems in the absence of space-occupying lesions. No intracranial infection, hypertensive encephalopathy, or hypercapnic respiratory failure is found, and the cerebrospinal fluid content is normal. It has been described in the past in association with hypervitaminosis A, hypovitaminosis A, hypoparathyroidism, prolonged corticosteroid therapy, chronic adrenal insufficiency, severe hypochromic microcytic anaemia, and pregnancy (Koch-Weser and Gilmore, 1967). Clinical uses of tetracycline have become associated with a number of unusual complications, one of which is benign intracranial hypertension described in infants as the "bulging fontanelle syndrome" (Gellis, 1956-7; Fields, 1961; O'Doherty, 1965; Folsom, 1966; Krevsky, 1968). There is only one recorded case of benign intracranial hypertension secondary to tetracycline therapy in an adult (Koch-Weser and Gilmore, 1967). The present report concerns a patient who received ampicillin and tetracycline sequentially and who was admitted to hospital with evidence of benign intracranial hypertension.