Pseudotumor Cerebri (PTC), a rare neurological disorder in which pressure inside the skull suddenly increases, has been linked to hormonal birth control products. In patients with PTC, the brain is affected in a way that appears to be – but is not – a tumor.
What is Nexplanon?
Manufactured by Merck, Nexplanon is a small plastic implant that is inserted under the skin of the upper arm to protect against pregnancy for up to three years. The implant is about 4 cm long and 2 mm in diameter. Nexplanon contains etonogestrel, a synthetic hormone, which is released into the blood continuously to prevent pregnancy.
Birth Control and Pseudotumor Cerebri
Pseudotumor cerebri occurs when excessive amounts of cerebrospinal fluid (CSF) accumulate inside the brain, causing symptoms that mimic those produced by a brain tumor. The disorder may be caused by an increase in fluid production or decrease in fluid absorption.
It is still not clearly understood why this occurs. However, certain medications including hormonal birth control products have been associated with pseudotumor cerebri. One hormone in particular, a second-generation synthetic progestin called levonorgestrel, was linked to PTC in 1995. Pseudotumor cerebri may also be referred to as idiopathic intracranial hypertension (IIH) or benign intracranial hypertension (BIH).
Symptoms of pseudotumor cerebri may include the following:
- Changes in vision
- Vision loss
- Papilledema (swelling of the optic nerve)
- Feeling dizzy or nauseated
- Neck stiffness
- Difficulty walking
- Persistent ringing in the ears (tinnitus)
Treatment for pseudotumor cerebri is aimed at the cause of the disorder. If, for example, a doctor determines that your PTC was caused by a birth control product, they will likely recommend discontinuing treatment in favor of a contraceptive with fewer potential side effects. However, you should NEVER stop taking a prescription medication without talking to your doctor first.
Other PTC treatments may include:
- Fluid or salt restriction
- Medications such as corticosteroids, acetazolamide and furosemide
- Shunting to relieve pressure from CSF accumulation
- Surgery to relieve pressure on the optic nerve
- Weight loss