Summary about Disease
Empty sella syndrome (ESS) is a condition where the pituitary gland, located at the base of the brain in a bony structure called the sella turcica, is flattened or shrunken. This is because the sella turcica is partially or completely filled with cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord. There are two types: primary ESS, which is usually caused by a small defect in the diaphragma sellae (the membrane covering the pituitary gland), and secondary ESS, which can be caused by pituitary tumor removal, radiation, or injury. In many cases, ESS doesn't cause any symptoms.
Symptoms
Many people with empty sella syndrome have no symptoms. When symptoms do occur, they can vary depending on the cause and severity of the condition. Possible symptoms include:
Headaches
Hormone imbalances (leading to irregular periods in women, decreased libido, or other endocrine issues)
Vision problems (blurry vision, double vision, or loss of peripheral vision, especially with enlarged sella)
High blood pressure
CSF rhinorrhea (leakage of cerebrospinal fluid from the nose, more common in secondary ESS)
Fatigue
Causes
Primary Empty Sella Syndrome: Usually caused by a small defect in the diaphragma sellae, the membrane that covers the pituitary gland. This allows CSF to enter the sella turcica, putting pressure on the pituitary gland and flattening it. The exact cause of the defect is often unknown. High blood pressure and obesity are associated with increased risk.
Secondary Empty Sella Syndrome: Caused by other conditions or events that damage the pituitary gland or the sella turcica. This can include:
Pituitary tumor removal
Radiation therapy to the pituitary gland
Surgery near the pituitary gland
Injury to the head
Infection
Sheehan's syndrome
Medicine Used
4. Medicine used There is no specific medication to "cure" empty sella syndrome itself. Treatment focuses on managing any hormonal deficiencies or other complications that may arise. Medications may include:
Hormone replacement therapy: If the pituitary gland is not producing enough of certain hormones (such as thyroid hormone, cortisol, growth hormone, or sex hormones), replacement therapy may be necessary. Specific medications depend on which hormones are deficient (e.g., levothyroxine for hypothyroidism, hydrocortisone for adrenal insufficiency, growth hormone injections, estrogen/progesterone or testosterone).
Medications for other symptoms: Medications to manage headaches, high blood pressure, or other related conditions.
Is Communicable
No, empty sella syndrome is not a communicable disease. It is not caused by an infection and cannot be transmitted from one person to another.
Precautions
There are no specific precautions to prevent primary empty sella syndrome, as the underlying cause is often unknown. For secondary empty sella syndrome, precautions depend on the underlying cause. For example, careful monitoring and management of pituitary tumors can help prevent secondary ESS.
How long does an outbreak last?
Empty sella syndrome is not an outbreak, as it's not an infectious disease. It's a chronic condition. Once it develops, it is present permanently, although the severity of symptoms and the need for treatment can vary over time.
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical examination: The doctor will ask about symptoms and perform a physical exam.
MRI or CT scan: These imaging tests can show the structure of the sella turcica and reveal the presence of CSF in the sella, confirming the diagnosis.
Hormone testing: Blood tests to measure the levels of various pituitary hormones (such as thyroid hormone, cortisol, growth hormone, prolactin, and sex hormones) to assess pituitary function.
Visual field testing: If vision problems are present, this test can help assess the extent of visual field loss.
Timeline of Symptoms
9. Timeline of symptoms The timeline of symptoms can vary greatly. Many individuals remain asymptomatic for life. In others, symptoms may develop gradually over time or may only appear after another medical event (e.g., surgery, radiation). There is no set timeline.
Important Considerations
Regular monitoring: Individuals with empty sella syndrome, especially those with hormonal deficiencies, require regular monitoring by an endocrinologist.
Hormone replacement adherence: If hormone replacement therapy is prescribed, it is crucial to take the medication as directed.
Headaches and Vision Changes: It is vital to report any new or worsening headaches, vision changes, or other concerning symptoms to a doctor promptly.
Differentiation from other conditions: ESS is generally benign but needs to be distinguished from other, more serious pituitary conditions that may require intervention.
Pregnancy: Women with ESS who are planning to become pregnant should consult with their endocrinologist and obstetrician to ensure proper hormone management during pregnancy.