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Recurrent Cushing’s Syndrome Manifesting as Pseudotumor Cerebri with Isolated Cranial Nerve Six Palsy.

Abstract

Tarek El-Halabi and Johnny Salameh

Pseudotumor cerebri has been described after exposure to steroids as well as following steroid withdrawal, causing adrenocortical insufficiency resulting in reduction of cerebrospinal fluid absorption and leading to intracranial hypertension. In our case, the patient had increased intracranial pressure caused by hypocortisolism. Cases of pseudotumor cerebri after resection of an ACTH-secreting adenoma has been reported in the literature, more often in children than in adults, and mostly occurring after steroid taper compared to steroid excess states. Our case highlights the importance of considering recurrence of Cushing’s syndrome in adults presenting with isolated cranial nerve palsy and pseudotumor cerebri.

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