Papilledema and Hydrocephalus Associated With Recurrent Polyneuritis

Abstract

PAPILLEDEMA in association with increased intracranial pressure has been documented infrequently in the Guillain-Barré syndrome (GBS),^1-11if one accepts as a requirement the authentication of normal visual acuity. We recently treated a patient who had these signs for 20 months and in whom communicating hydrocephalus developed. This phenomenon has not previously been reported. We are reporting our observations in detail, since they may help to clarify the genesis of these complications. Theories of the pathogenesis of papilledema in GBS can be grouped into those implying a relation between increased cerebrospinal fluid (CSF) protein and elevated intracranial pressure, and those that state that cerebral edema is the most prominent causative factor. In our patient, at the time of operation for subtemporal decompression, there was no sign of brain swelling and he did not improve following this procedure. However, papilledema and increased intracranial pressure resolved promptly after the creation of a