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Stephen D. Silberstein, MD; John Marcelis, MD
Comprehensive Headache Center One Penn Blvd Philadelphia, Pa 19144

Arch Neurol. 1992;49(1):14.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—Our article¹ was intended to describe an unusual group of patients with headache, increased intracranial pressure, and absence of papilledema. The differential diagnosis of increased intracranial pressure and related syndromes is extensive, and it was not our intention to review all such processes.

With review of medical records, the symptoms of pharyngeal snoring, insomnia, restless or altered sleep pattern, nocturia, daytime somnolence, hallucinations, and hearing loss that are associated with obstructive sleep apnea were absent in our patients.²

On the other hand, female predominance, pulsatile tinnitus, history of head trauma, empty sella syndrome, and chronic daily headache of great severity are seen commonly in our patients, but not necessarily in obstructive sleep apnea.

Systemic hypertension is more common in obese individuals and may reflect the fact that both groups of patients are obese, rather than a true distinguishing characteristic of either syndrome. Although low protein concentration . . . [Full Text PDF of this Article]

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