Idiopathic intracranial hypertension associated with tetracycline use in fraternal twins: case reports and review.

Fraternal twin sisters developed idiopathic intracranial hypertension (IIH) shortly after beginning tetracycline for treatment of acne. We reviewed from the literature 19 familial cases of IIH and 37 cases of IIH associated with tetracycline usage. Among the 37 combined adult and pediatric cases, 26 of 37 had resolution of signs or symptoms of IIH within hours to days of stopping the antibiotic, and rapid recurrence with reinitiation of drug occurred in 4 of 37. We suggest that these cases may be tetracycline-induced, may be related to an underlying genetic susceptibility, and support the notion of multifactorial etiologies for IIH.