25th June 2023

A 30-year-old lady presents with a gradually worsening headache, with associated nausea and double vision

A 30-year-old lady presents with a gradually worsening headache, with associated nausea and double vision. She has noticeably dilated pupils bilaterally and has diplopia on lateral gaze bilaterally. She has a background of polycystic ovarian syndrome, obstructive sleep apnoea and has a BMI of 35. Fundoscopy reveals Grade 2 to 3 papilloedema. She has no other neurological signs and is otherwise well. A CT head and venogram finds no obvious intracranial abnormalities.

Given her likely diagnosis, what is the most effective long-term management option for her condition?