How to manage papilledema in a 41-year-old female?

Question

Hi doctor,

I have been told I have papilledema. My neurologist has told me to wait and see and return in a month. I am currently seeing them for trigeminal neuralgia, and I am taking Baclofen and Oxycarbpazamine. I am a 41-year-old female with 5 feet height. I have had brief vision loss in my right eye for five years. My left eye has an enlarged blind spot but mostly the same vision. I have daily headaches with nausea and vomiting, and no tests have been done. Is this the right course of action?

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I would like to know further details about your problem. Regarding headaches, I have a few questions:

Since when did you start to have headaches? You feel that headache in which areas of your head, and from where it started? What kind of headache is this? Do you have heaviness, throbbing, stretching, bursting, shooting pain, electric current-like pain, or some other kind? Is it severe, moderate, or mild? The headache is episodic only or some kind of persistent headache? If episodic headache, how long does one episode of it last (from onset to complete relief without medication)? How frequent were these headache episodes before and now? How many times in a week? Is there any vomiting or feeling of vomiting? Do you have watering from the eye, redness in the eye, or nasal congestion during headache? Have you noticed any trigger factors for this headache?

Regarding trigeminal neuralgia, answer these:

Since when do you have trigeminal neuralgia? Is it controlled on Baclofen and Oxcarbazepine? Papilledema with headaches points toward the possibility of raised intracranial pressure. Are you taking any other medication too, other than Baclofen and Oxcarbazepine, or any hormonal preparation?

I suggest you do the following investigations:

1. MRI (magnetic resonance imaging) brain, including orbital sections with MR venogram with contrast.

2. Ophthalmology examination to check for intraocular pressure

3. Serum vitamin D3.

Revert with the above-mentioned information for better understanding and further judgment.

Kind regards.