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Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study.
J Neurol. 2011 Feb; 258(2):277-83.JN

Abstract

Idiopathic intracranial hypertension (IIH) is a disorder of raised intracranial pressure (ICP) in the absence of identifiable pathology. The purpose of this study was to evaluate the clinical presentation and monitor a 3-month course using frequent optical coherence tomography (OCT) evaluations, visual field testings and lumbar opening pressure measurements. A longitudinal study of 17 patients with newly diagnosed IIH and 20 healthy overweight controls were included in the study. Peripapillary retinal nerve fiber layer thickness (RNFLT) and retinal thickness (RT) measurements (Stratus OCT-3, fast RNFL 3.4 protocol), and Humphrey visual field testing were evaluated at regular intervals. Repeat lumbar puncture was performed at final visit (n = 13). The diagnostic delay was 3 months and initial symptoms were headache (94%), visual blurring (82%) and pulsatile tinnitus (65%). Complete clinical remission was achieved in 65%, partial in 29% and unchanged symptoms in 6%. Total average RNFLT and RT decreased significantly during the follow-up period (p < 0.0001 and p < 0.0001, respectively). Changes in RNFLT and RT correlated with improvements in visual field mean deviation (MD) (RNFLT: p = 0.006; RT: p = 0.03) and pattern standard deviation (PSD) (RNFLT: p = 0.002; RT: p = 0.003). In patients with weight-loss >3.5% of BMI, ICP decreased significantly (p = 0.0003). In patients with weight-loss <3.5% of BMI, changes in ICP were insignificant (p = 0.6). OCT combined with visual field testing may be a valuable objective tool to monitor IIH patients and the short term IIH outcome is positive. Weight-loss is the main predictor of a favorable outcome with respect to CSF pressure.

Authors+Show Affiliations

Department of Neurology, Danish Headache Center, Glostrup Hospital, University of Copenhagen, Nordre Ringvej 57, 2600, Glostrup, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20853113

Citation

Skau, Maren, et al. "Disease Activity in Idiopathic Intracranial Hypertension: a 3-month Follow-up Study." Journal of Neurology, vol. 258, no. 2, 2011, pp. 277-83.
Skau M, Sander B, Milea D, et al. Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study. J Neurol. 2011;258(2):277-83.
Skau, M., Sander, B., Milea, D., & Jensen, R. (2011). Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study. Journal of Neurology, 258(2), 277-83. https://doi.org/10.1007/s00415-010-5750-x
Skau M, et al. Disease Activity in Idiopathic Intracranial Hypertension: a 3-month Follow-up Study. J Neurol. 2011;258(2):277-83. PubMed PMID: 20853113.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study. AU - Skau,Maren, AU - Sander,Birgit, AU - Milea,Dan, AU - Jensen,Rigmor, Y1 - 2010/09/19/ PY - 2010/07/23/received PY - 2010/09/03/accepted PY - 2010/9/21/entrez PY - 2010/9/21/pubmed PY - 2011/6/9/medline SP - 277 EP - 83 JF - Journal of neurology JO - J Neurol VL - 258 IS - 2 N2 - Idiopathic intracranial hypertension (IIH) is a disorder of raised intracranial pressure (ICP) in the absence of identifiable pathology. The purpose of this study was to evaluate the clinical presentation and monitor a 3-month course using frequent optical coherence tomography (OCT) evaluations, visual field testings and lumbar opening pressure measurements. A longitudinal study of 17 patients with newly diagnosed IIH and 20 healthy overweight controls were included in the study. Peripapillary retinal nerve fiber layer thickness (RNFLT) and retinal thickness (RT) measurements (Stratus OCT-3, fast RNFL 3.4 protocol), and Humphrey visual field testing were evaluated at regular intervals. Repeat lumbar puncture was performed at final visit (n = 13). The diagnostic delay was 3 months and initial symptoms were headache (94%), visual blurring (82%) and pulsatile tinnitus (65%). Complete clinical remission was achieved in 65%, partial in 29% and unchanged symptoms in 6%. Total average RNFLT and RT decreased significantly during the follow-up period (p < 0.0001 and p < 0.0001, respectively). Changes in RNFLT and RT correlated with improvements in visual field mean deviation (MD) (RNFLT: p = 0.006; RT: p = 0.03) and pattern standard deviation (PSD) (RNFLT: p = 0.002; RT: p = 0.003). In patients with weight-loss >3.5% of BMI, ICP decreased significantly (p = 0.0003). In patients with weight-loss <3.5% of BMI, changes in ICP were insignificant (p = 0.6). OCT combined with visual field testing may be a valuable objective tool to monitor IIH patients and the short term IIH outcome is positive. Weight-loss is the main predictor of a favorable outcome with respect to CSF pressure. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/20853113/Disease_activity_in_idiopathic_intracranial_hypertension:_a_3_month_follow_up_study_ L2 - https://dx.doi.org/10.1007/s00415-010-5750-x DB - PRIME DP - Unbound Medicine ER -