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Papilledema and Peripheral Neuropathies

Mathis, Stéphane MD, PhD*,†; Le Masson, Gwendal MD, PhD*,†; Soulages, Antoine MD*; Duval, Fanny MD*,†; Solé, Guilhem MD*,†; Boissonnot, Michèle MD; Lathière, Thomas MD§; Bonduelle, Thomas MD*; Carla, Louis MD*; Nadal, Louis MD*; Baron, Clément MD; Balaboi, Irina MD; Ciron, Jonathan MD#; Vallat, Jean-Michel MD**,††

doi: 10.1097/NRL.0000000000000250
Case Report/Case Series
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Introduction: Papilledema is a common sign in ophthalmology and is typically associated with increased intracranial pressure (ICP) in neurological diseases. Since the beginning of the 20th century, some cases of papilledema have been reported in association with acute or chronic inflammatory neuropathies.

Case Report: We describe a 42-year-old man with acute-onset inflammatory polyradiculoneuropathy and bilateral papilledema.

Conclusions: Based on a personal case report and from an extensive review of the medical literature, we identify 2 distinct patterns. First, radiculoneuropathy may be a consequence of intracranial pressure (peripheral nerve involvement corresponding to a “false localizing sign”). Second, papilledema may occur after the onset of inflammatory neuropathy. For such cases, the pathophysiological mechanism remains unknown (eg, reactional inflammatory processes or actions of unknown autoantibodies) and requires further elucidation.

*Department of Neurology, Nerve-Muscle Unit

Referal Center for Neuromuscular Disorders, CHU Bordeaux (Pellegrin Hospital), Bordeaux

Departments of Ophthalmology

Neurology, CHU Poitiers (La Milétrie University Hospital), Poitiers

Departments of §Ophthalmology

**Neurology, CHU Limoges (Dupuytren University Hospital), Limoges

††Referal Center for ‘Rare Peripheral Neuropathies’, CHU Limoges (Dupuytren University Hospital)

Department of Neurology, Niort Hospital, Niort

#Department of Neurology, CHU Toulouse (Pierre-Paul Riquet University Hospital), Toulouse, France

The authors declare no conflict of interest.

Correspondence to: Stéphane Mathis, MD, PhD, Department of Neurology, Nerve-Muscle Unit, CHU Bordeaux (Pellegrin University Hospital), Place Amélie Raba-Léon, 33000 Bordeaux, France. E-mail: stephane.mathis@chu-bordeaux.fr.

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