{"id":66,"date":"2010-01-10T02:25:00","date_gmt":"2010-01-10T02:25:00","guid":{"rendered":"http:\/\/healingmusicenterprises.com\/brain_blog\/?p=66"},"modified":"2015-09-28T03:21:50","modified_gmt":"2015-09-28T03:21:50","slug":"pseudotumor-cerebri-how-can-music-make-a-difference","status":"publish","type":"post","link":"https:\/\/healingmusicenterprises.com\/brain_blog\/2010\/01\/pseudotumor-cerebri-how-can-music-make-a-difference\/","title":{"rendered":"Pseudotumor cerebri: how can music make a difference?"},"content":{"rendered":"
Tweet<\/a><\/div>\n
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Recently a friend of mine was given this diagnosis:\u00a0 Pseudotumor cerebri.\u00a0 She had been having terrible headaches and was experiencing increasingly blurry vision.\u00a0 Today she had an MRI and a spinal tap.\u00a0 Unfortunately, the spinal tap did not get any fluid so she has to have one done again on Monday.\u00a0 The first thing I asked myself was whether or not music might be able to help.\u00a0 Now hopefully on Monday she will at least take her iPod with her and have queued up some music that will distract her from the procedure.<\/p>\n

There are many medical procedures that can be greatly eased simply by listening\u00a0to music through headphones or on an iPod.\u00a0 Think about this when you’re told that you need a certain procedure and if possible, plan the music that you want to listen to very specifically in advance.\u00a0 I can program headphones for you, but you can also do it for yourself if you have time.
\nPapilledema is defined as disc swelling produced by increased ICP; it may be asymmetric, UL, or BL. True optic disc swelling or edema can be a very ominous sign.\u00a0 Acutely, the vision, color vision, and pupillary responses are normal, but the blind spot is increased on visual field testing. Chronic forms lead to loss of vision and loss of visual fields. Fortunately, most perceived optic disc swelling is a manifestation of a congenital optic disc variation.<\/p>\n

Differential Diagnosis<\/p>\n

Pseudotumor cerebri<\/p>\n

\u2013Other symptoms: Headache, nausea, and vomiting all worse in morning, transient visual obscurations, diplopia<\/p>\n

\u2013Diagnosis includes increased ICP, normal imaging, normal CSF<\/p>\n

\u2013More common in obese females<\/p>\n

Optic neuritis<\/p>\n

\u2013May be associated with postviral syndromes or meningoencephalitis<\/p>\n

\u2013Loss of vision, pain on eye movement<\/p>\n

\u2013Vision usually improves within a few weeks, but not full recovery<\/p>\n

Optic neuropathy<\/p>\n

\u2013Compressive: Associated with NF1 and optic nerve glioma, presents with progressive visual loss, strabismus, nystagmus, proptosis<\/p>\n

\u2013Infiltrative: From cancers (leukemias, lymphomas), infection, or inflammation (sarcoidosis, TB, toxocariasis, toxoplasmosis, CMV); optic disc swelling, vision loss, and hemorrhages<\/p>\n

\u2013Toxic\/nutritional optic neuropathy: Symmetric neuropathy from nutritional deficiency (thiamine, B12), drugs (tobacco\/alcohol, chloramphenicol, rifampin), toxins (lead, methanol); visual field and vision loss; may recover with treatment<\/p>\n

\u2013Leber optic neuropathy: Mitochondrial DNA transmission, presents late teens to middle 20s; visual field and vision loss, may spontaneously improve<\/p>\n

Increased ICP: Idiopathic intracranial hypertension, intracranial hemorrhage, space-occupying lesion<\/p>\n

Growth hormone supplementation<\/p>\n

Retinal hemorrhage and loss of vision<\/p>\n

Retinal vein occlusion<\/p>\n

Malignant hypertension: Associated with retinal hemorrhage, exudates, and cotton wool spots<\/p>\n

Optic neuropathy, nonarteritic or arteritic<\/p>\n

Demyelinating disease<\/p>\n

Infectious conditions: Toxoplasmosis, Lyme disease, Bartonella; hard exudates may be visible funduscopically<\/p>\n

Workup and Diagnosis<\/p>\n

History<\/p>\n

\u2013History of HA, nausea or vomiting, recent viral illness<\/p>\n

\u2013Family history of visual loss, neurologic disorder<\/p>\n

\u2013PMH or signs and symptoms consistent with known systemic diseases; e.g., hypertension, diabetes, thyroid disease, growth hormone therapy<\/p>\n

\u2013Nutritional deficiencies; exposure to toxins such as tobacco or alcohol; recent drug use; exposure to ticks and animals<\/p>\n

Physical exam<\/p>\n

\u2013Visual acuity, confrontational visual fields, pupillary response, extraocular muscle movements, proptosis<\/p>\n

\u2013Dilated fundus evaluation<\/p>\n

\u2013Neurologic exam for signs and symptoms of demyelinating disease, localizing deficit<\/p>\n

Labs<\/p>\n

\u2013Titers for CMV, Lyme, toxocariasis, toxoplasmosis<\/p>\n

Radiology<\/p>\n

\u2013CT or MRI of the brain and orbits for suspicion of intracranial mass, mass effect or hemorrhage<\/p>\n

Studies<\/p>\n

\u2013Lumbar puncture may be indicated to establish presence or absence of, or to relieve, increased intracranial pressure<\/p>\n

Ophthalmologic consultation to rule out congenital variation to avoid unnecessary and expensive differential testing<\/p>\n

Treatment<\/p>\n

Condition-dependent: Treatment of underlying systemic disease is often the only treatment<\/p>\n

Pseudotumor cerebri and other causes of intracranial hypertension: Weight loss, Diamox or Lasix, planned recumbency, LP shunt or optic nerve sheath fenestration if loss of visual function<\/p>\n

Space-occupying lesion or hemorrhage: Neurosurgical intervention<\/p>\n

Meningoencephalitis: IV antibiotics<\/p>\n

Infectious optic neuropathy: Treat underlying cause and consider systemic steroids (controversial)<\/p>\n

Optic neuritis: IV (not oral) steroids<\/p>\n

Optic nerve glioma treatment controversial: Observation if slowly progressive, resection if only one nerve involved, radiation if chiasm involved, shunts if increased ICP<\/p>\n

Toxic or nutritional: Stop offending toxin or supply nutritional supplementation<\/p>\n","protected":false},"excerpt":{"rendered":"

Tweet Recently a friend of mine was given this diagnosis:\u00a0 Pseudotumor cerebri.\u00a0 She had been having terrible headaches and was experiencing increasingly blurry vision.\u00a0 Today she had an MRI and a spinal tap.\u00a0 Unfortunately, the spinal tap did not get any fluid so she has to have one done again on Monday.\u00a0 The first thing […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[55],"tags":[140],"yoast_head":"\nPseudotumor cerebri: how can music make a difference? - The Brain and Music<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/healingmusicenterprises.com\/brain_blog\/2010\/01\/pseudotumor-cerebri-how-can-music-make-a-difference\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pseudotumor cerebri: how can music make a difference? 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