Idiopathic intracranial hypertension Quiz: Ace Your Exams
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A 31-year-old woman presents to the primary care clinic for evaluation of a worsening headache for the past week. One month ago, she developed a holocephalic headache, that was worse with coughing and sneezing, and she had blurry vision. Fundoscopy at that time revealed bilateral papilledema. Visual field-testing showed an enlarged blind spot bilaterally. Brain magnetic resonance imaging was normal. She was prescribed acetazolamide at that time. She stopped taking her acetazolamide two weeks ago because she developed paresthesia, altered taste, and nausea. Temperature is 37°C (98.6°F), pulse is 68/min, respirations are 22/min, and blood pressure is 120/76. BMI is 30 kg/m2. Fundoscopy reveals bilateral disc elevation and blurred optic disc margins which are stable compared to previous ones, and visual field-testing is unchanged with an enlarged blind spot seen bilaterally. Visual acuity is 20/20 in both eyes. In addition to weight reduction efforts and headache management, which of the following is the most appropriate next step in management?
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