Empty sella syndrome
Overview
Empty Sella Syndrome (ESS) is a disorder that involves the sella turcica, a bony structure at the base of the brain that surrounds and protects the pituitary gland. ESS is a condition that is often discovered during tests for pituitary disorders, when radiological imaging of the pituitary gland reveals a sella turica that appears to be empty.
Symptoms
Symptoms of primary empty sella syndrome include: * Erectile dysfunction (impotence) * Irregular or absent menstruation * Low sexual desire (low libido) * Occasional symptoms resulting from high prolactin levels Often, there are no symptoms or loss of pituitary function.
Causes
The pituitary gland is a small gland located at the base of the brain. It sits in a saddle-like compartment in the skull called the "sella turcica," which in Latin means "Turkish saddle." When the pituitary gland shrinks or becomes flattened, it cannot be seen on MRI scans, giving the appearance of an "empty sella." This is referred to as empty sella syndrome. The pituitary makes several hormones that control the other glands in the body, including the: * Adrenal glands * Ovaries * Testicles * Thyroid
Diagnosis
In addition to a complete medical history and medical examination, diagnostic procedures for empty sella syndrome may include: * x-ray of the skull * computed tomography (CT or CAT scan) - a non-invasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary x-ray * magnetic resonance imaging (MRI) - a non-invasive procedure that produces two-dimensional views of an internal organ or structure, especially the brain or spinal cord
Prognosis
Primary empty sella syndrome does not have adverse health consequences, and it does not alter life expectancy.
Treatment
For primary empty sella syndrome: * There is no specific treatment if pituitary function is normal. * Medications, such as bromocriptine, which lower prolactin levels, may be prescribed if the prolactin levels are high and interfering with function of the ovaries or testes. For secondary empty sella syndrome: * Treatment involves replacing the hormones that are lacking.