Lyme Papillitis Can Mimic Idiopathic Intracranial Hypertension

Optic nerve head edema is a non-specific finding. When bilateral and especially when marked, the etiology is often elevation of intracranial pressure (ICP). We present a patient who had bilateral disc edema thought to be secondary to idiopathic intracranial hypertension (IIH) based in part on MRI findings, who had dramatic improvement in the edema despite lack of consistent treatment with acetazolamide, and was later found to have Lyme papillitis