Risk of developing pseudotumor cerebri in women using a levonorgesteral intrauterine device
Reviewed by Claire Howard

Pseudotumor cerebri (PCT) is a disorder causing increased intracranial pressure without a mass lesion, usually seen in obese women of childbearing age. Idiopathic intracranial hypertension is an idiopathic form of the disorder, but several medications have been associated with the secondary form, pseudotumor cerebri syndrome, including tetracycline and minocycline. The authors evaluate the use of levonorgesterel-eluting intrauterine devices (LNG-IUS) using a population of those using the device compared to a control group. There have been previous associations of pseudotumor cerebri with levonorgesterel, prompting this current study. Results from this series showed that PCT prevalence was approximately 0.18% and 0.15% in the LNG-IUS population versus 0.02% and 0.04% in the non-LNG-IUS population, with no significant differences in PTC signs and symptoms among the two groups. The authors suggest that women with an LNG-IUS may have increased risk of developing PTC but the investigation does not suggest an LNG-IUS can cause PTC. The authors recommend that physicians caring for patients with PTC should obtain a birth control history from all patients. Caution should be taken with the removal of these devices as the benefit of contraception for these women likely outweighs the risk.

An estimation of the risk of pseudotumor cerebri among users of the levonorgestrel intrauterine device.
Valenzuela RM, Rai R, Kirk BH, et al.
NEURO-OPHTHALMOLOGY
2017;41(4):192-7.