VITAMIN-A INTOXICATION CAUSING PAPILLEDEMA AND SIMULATING ACUTE ENCEPHALITIS

Abstract

Vitamin-A intoxication in two monozygotic brothers treated with large doses of vitamin A for psoriasis is reported. In spite of the same vitamin-A dose, 300,000 I.U. daily, given over exactly the same period, one was subjectively well, whereas the other was severely affected with a clinical picture at first diagnosed as encephalitis. On steroid medication, some improvement occurred. The correct diagnosis was made from the elevated serum level of calcium, tender hyperosteroses of the long bones, papilledema, the history of an enormous and long-standing vitamin-A intake, and increased serum levels of vitamin A. After 6 months, the patient felt well, but changes in reflexes, EEG and ophthalmoscopy persisted. After 12 months, the papilledema and the neurological signs had disappeared.