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Idiopathic intracranial hypertension in pregnancy.
J Neurol. 2002 Aug; 249(8):1078-81.JN

Abstract

OBJECTIVE

Since idiopathic intracranial hypertension (IIH) is most prevalent in obese women of childbearing age, concerns arise regarding the impact of pregnancy on the disorder and the potential teratogenicity of some therapeutic agents. We evaluated the course, management of pregnant IIH patients and the visual and pregnancy outcomes.

METHODS

Case series of pregnant women diagnosed with IIH. IIH symptoms, neuro-ophthalmological findings, IIH management, visual and pregnancy outcomes were documented.

RESULTS

Among 240 women with IIH, 12 had 16 pregnancies. Ten had headaches, five had transient visual obscurations, and three had diplopia. Visual acuity was severely decreased in one and mildly reduced in three women. Six had marked and six had mild bilateral papilledema. Visual field loss occurred in four women. Visual symptoms and loss improved for the duration of the pregnancy after diagnostic lumbar puncture and salt restricted diet in three. Two additional women needed continuous spinal drainage for two days. One woman was treated with acetazolamide and medical abortion. The one woman with severe vision loss had fenestration of one optic nerve sheath and a lumboperitoneal shunt as well as corticosteroids and was the only case with permanent field loss. After intervention, visual acuity improved in all cases with reduced vision. There were 10 full-term normal deliveries, three missed abortions, one therapeutic abortion and two intrauterine fetal deaths.

CONCLUSIONS

IIH appears to present during the first two trimesters of pregnancy with typical symptoms and findings. Visual outcome is similar as for non-pregnant women. Treatment should be oriented towards dietary control, without ketosis. Repeated spinal fluid drainage, if needed, can be helpful.

Authors+Show Affiliations

Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12195458

Citation

Huna-Baron, Ruth, and Mark J. Kupersmith. "Idiopathic Intracranial Hypertension in Pregnancy." Journal of Neurology, vol. 249, no. 8, 2002, pp. 1078-81.
Huna-Baron R, Kupersmith MJ. Idiopathic intracranial hypertension in pregnancy. J Neurol. 2002;249(8):1078-81.
Huna-Baron, R., & Kupersmith, M. J. (2002). Idiopathic intracranial hypertension in pregnancy. Journal of Neurology, 249(8), 1078-81.
Huna-Baron R, Kupersmith MJ. Idiopathic Intracranial Hypertension in Pregnancy. J Neurol. 2002;249(8):1078-81. PubMed PMID: 12195458.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Idiopathic intracranial hypertension in pregnancy. AU - Huna-Baron,Ruth, AU - Kupersmith,Mark J, PY - 2002/8/27/pubmed PY - 2002/12/27/medline PY - 2002/8/27/entrez SP - 1078 EP - 81 JF - Journal of neurology JO - J Neurol VL - 249 IS - 8 N2 - OBJECTIVE: Since idiopathic intracranial hypertension (IIH) is most prevalent in obese women of childbearing age, concerns arise regarding the impact of pregnancy on the disorder and the potential teratogenicity of some therapeutic agents. We evaluated the course, management of pregnant IIH patients and the visual and pregnancy outcomes. METHODS: Case series of pregnant women diagnosed with IIH. IIH symptoms, neuro-ophthalmological findings, IIH management, visual and pregnancy outcomes were documented. RESULTS: Among 240 women with IIH, 12 had 16 pregnancies. Ten had headaches, five had transient visual obscurations, and three had diplopia. Visual acuity was severely decreased in one and mildly reduced in three women. Six had marked and six had mild bilateral papilledema. Visual field loss occurred in four women. Visual symptoms and loss improved for the duration of the pregnancy after diagnostic lumbar puncture and salt restricted diet in three. Two additional women needed continuous spinal drainage for two days. One woman was treated with acetazolamide and medical abortion. The one woman with severe vision loss had fenestration of one optic nerve sheath and a lumboperitoneal shunt as well as corticosteroids and was the only case with permanent field loss. After intervention, visual acuity improved in all cases with reduced vision. There were 10 full-term normal deliveries, three missed abortions, one therapeutic abortion and two intrauterine fetal deaths. CONCLUSIONS: IIH appears to present during the first two trimesters of pregnancy with typical symptoms and findings. Visual outcome is similar as for non-pregnant women. Treatment should be oriented towards dietary control, without ketosis. Repeated spinal fluid drainage, if needed, can be helpful. SN - 0340-5354 UR - https://www.unboundmedicine.com/medline/citation/12195458/Idiopathic_intracranial_hypertension_in_pregnancy_ L2 - https://dx.doi.org/10.1007/s00415-002-0791-4 DB - PRIME DP - Unbound Medicine ER -