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A 19-year-old woman (body mass index 19 kg/m2) presented to the emergency department with a 1-week history of postural headaches and visual obscurations, worse when supine. She had bilaterally reduced visual acuity, enlarged blind spots and papilloedema (figure 1A,B). The remaining neurological examination, and a CT scan of head, was normal. She was admitted for investigation of her papilloedema.
Further evaluation identified a recent history of palatal …
Contributors SK: writing first draft, revision of manuscript, contribution to figure 1, obtaining patient consent. EV: revision of manuscript, rheumatology expertise, contribution to figure 1. AP: revision of manuscript, ophthalmology expertise, contribution to figure 1. SC: revision of manuscript, neuroradiology expertise; contribution to figure 1. OB: revision of manuscript, ophthalmology expertise, contribution to figure 1. JA: conception of idea, neurologist responsible for overall medical care of patient, revision of manuscript, contribution to figure 1.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests EV has received research grants paid to his employer and consulting fees from Roche and Genentech. JA receives medical textbook royalties from Taylor and Francis, holds shares in ClearSky Medical Diagnostics, has received speaker fees from Allergan & Stada, and advisory board payments from Abbvie and Merz.
Provenance and peer review Not commissioned; externally peer reviewed by Susan Mollan, Birmingham, UK.