Pseudotumor cerebri induced by minocycline therapy for acne vulgaris.

BACKGROUND We report a case of a young girl who developed pseudotumor cerebri while taking minocycline for acne vulgaris. CASE A 16-year-old girl without a history of menstrual irregularity, weighing 60 kg (body mass index: 26.0%) presented with a history of 1 week of headache and sudden onset of a horizontal diplopia. OBSERVATION Examination revealed bilateral papilledema and an abduction deficit in her right eye. Her cerebrospinal fluid had an opening pressure of 400 mm H(2)O and a normal composition. Following normal findings on computed tomography and magnetic resonance imaging, a diagnosis of pseudotumor cerebri was made. She reported receiving minocycline to treat acne vulgaris during the previous 3 weeks. The headache resolved with withdrawal of minocycline. The diplopia and papilledema resolved after two lumbar punctures, although the visual field defects persisted. The minocycline concentrations in the serum and cerebrospinal fluid taken after cessation of the drug were below the detectable level. CONCLUSION The role of minocycline should be considered and routine ophthalmologic examination during minocycline treatment should be performed when pseudotumor cerebri occurs in patients treated for acne vulgaris.