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Cephalalgia : An International Journal... Aug 2023The quality of clinical trials is essential to advance treatment, inform regulatory decisions and meta-analysis. With the increased incidence of idiopathic intracranial...
The quality of clinical trials is essential to advance treatment, inform regulatory decisions and meta-analysis. With the increased incidence of idiopathic intracranial hypertension and the emergence of clinical trials for novel therapies in this condition, the International Headache Society aims to establish guidelines for designing state-of-the-art controlled clinical trials for idiopathic intracranial hypertension.
Topics: Humans; Headache; Pseudotumor Cerebri; Controlled Clinical Trials as Topic
PubMed: 37661711
DOI: 10.1177/03331024231197118 -
Reviews in Neurological Diseases 2010Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology often encountered in neurologic practice. It produces nonlocalizing symptoms and signs of... (Review)
Review
Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology often encountered in neurologic practice. It produces nonlocalizing symptoms and signs of raised intracranial pressure and, when left untreated, can result in severe irreversible visual loss. It most commonly occurs in obese women of childbearing age, but it can also occur in children, men, nonobese adults, and older adults. Although it is frequently associated with obesity, it can be associated with other conditions, such as obstructive sleep apnea and transverse cerebral venous sinus stenoses. Recent identification of subgroups at high risk for irreversible visual loss, including black patients, men, and patients with fulminant forms of IIH, help guide the optimal management and follow-up. Ongoing studies of venous anatomy and physiology in IIH patients, as well as a recently begun randomized clinical treatment trial, should provide further insight into this common yet poorly understood syndrome.
Topics: Comorbidity; Female; Humans; Male; Obesity; Pregnancy; Pseudotumor Cerebri; Sex Characteristics; Sinus Thrombosis, Intracranial; Sleep Apnea Syndromes
PubMed: 20944524
DOI: No ID Found -
American Journal of Ophthalmology Dec 2020Comparisons between clinical features of tetracycline-induced pseudotumor cerebri (PTC-T) and those of idiopathic intracranial hypertension (IIH) are absent in the... (Comparative Study)
Comparative Study
PURPOSE
Comparisons between clinical features of tetracycline-induced pseudotumor cerebri (PTC-T) and those of idiopathic intracranial hypertension (IIH) are absent in the literature. We hypothesized that significant clinical differences between these etiologies exist and could be better understood by retrospective analysis.
DESIGN
Retrospective cohort study.
METHODS
We reviewed patients diagnosed with pseudotumor cerebri syndrome (PTCS) at our center and identified those who developed PTC-T after treatment with a tetracycline-class antibiotic and those with IIH. Groups were compared by demographics, body mass index, ophthalmic examination, treatment, clinical course, and visual outcomes.
RESULTS
We identified 52 cases of PTC-T and 302 cases of IIH. Obesity rates were significantly different (43.8% for PTC-T vs 79.2% for IIH, P < .001). The mean age at diagnosis was younger for PTC-T (19.8 years vs 28.1 years for IIH, P < .001). Diplopia was more common with PTC-T (40.4% vs 20.1% for IIH, P = .001). The mean illness duration was shorter for PTC-T (18.3 weeks vs 62.9 weeks for IIH, P <.0001). Recurrence rates were significantly different (4.0% for PTC-T vs 16.5% for IIH, P <.001). The frequency of surgical intervention was similar. Vision loss was uncommon but occurred with similar frequency.
CONCLUSION
We identified significant clinical differences but also identified important similarities between the 2 groups. There appear to be nonobese patients who develop PTC-T, discontinue the antibiotic, and never develop PTCS again. There are other patients who develop PTC-T, discontinue the antibiotic, and later develop IIH. We conclude that PTC-T represents a spectrum of disease in susceptible individuals.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Body Mass Index; Child; Diagnostic Imaging; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pseudotumor Cerebri; Retrospective Studies; Tetracycline; Young Adult
PubMed: 32738227
DOI: 10.1016/j.ajo.2020.07.037 -
Archivos Argentinos de Pediatria Apr 2014
Topics: Child; Female; Humans; Pseudotumor Cerebri
PubMed: 24584797
DOI: 10.5546/aap.2014.198 -
Journal of the National Medical... Oct 1991This article reviews the diagnosis and management of pseudotumor cerebri. Signs and symptoms of the syndrome are reviewed along with current recommended treatment. If... (Review)
Review
This article reviews the diagnosis and management of pseudotumor cerebri. Signs and symptoms of the syndrome are reviewed along with current recommended treatment. If the diagnosis is made early in the clinical course of patients with the disorder, minimal morbidity is incurred.
Topics: Humans; Papilledema; Pseudotumor Cerebri
PubMed: 1800768
DOI: No ID Found -
Romanian Journal of Ophthalmology 2020We present the case of a 12-year-old boy with bilateral papilledema, relating moderate symptomatology and without an important medical history. Ophthalmological...
We present the case of a 12-year-old boy with bilateral papilledema, relating moderate symptomatology and without an important medical history. Ophthalmological examination revealed a significant alteration of visual acuity, an important papilledema and macular edema in both eyes. Further investigations excluded infectious and autoimmune diseases, intracranial masses and congenital affliction. Because of an elevated opening pressure in lumbar puncture procedure, the diagnosis of intracranial hypertension was confirmed. After two weeks of treatment with corticosteroids, carbonic anhydrase inhibitor and hyperosmotic drug, the patient had an important structural and functional ophthalmological improvement.
Topics: Carbonic Anhydrase Inhibitors; Child; Humans; Male; Optic Disk; Papilledema; Pseudotumor Cerebri; Tomography, Optical Coherence; Visual Acuity
PubMed: 33367182
DOI: 10.22336/rjo.2020.66 -
Journal of Neuro-ophthalmology : the... Sep 2022To determine whether the use of a tetracycline-class antibiotic is associated with an increased risk of developing pseudotumor cerebri syndrome (PTCS).
BACKGROUND
To determine whether the use of a tetracycline-class antibiotic is associated with an increased risk of developing pseudotumor cerebri syndrome (PTCS).
METHODS
We identified patients in the University of Utah Health system who were prescribed a tetracycline-class antibiotic and determined what percentage of those individuals were subsequently diagnosed with PTCS secondary to tetracycline use. We compared this calculation to the number of patients with PTCS unrelated to tetracycline use.
RESULTS
Between 2007 and 2014, a total of 960 patients in the University system between the ages of 12 and 50 were prescribed a tetracycline antibiotic. Among those, 45 were diagnosed with tetracycline-induced PTCS. We estimate the incidence of tetracycline-induced PTCS to be 63.9 per 100,000 person-years. By comparison, the incidence of idiopathic intracranial hypertension (IIH) is estimated to be less than one per 100,000 person-years (Calculated Risk Ratio = 178).
CONCLUSIONS
Although a causative link between tetracycline use and pseudotumor cerebri has yet to be firmly established, our study suggests that the incidence of pseudotumor cerebri among tetracycline users is significantly higher than the incidence of IIH in the general population.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Child; Humans; Incidence; Middle Aged; Pseudotumor Cerebri; Tetracycline; Young Adult
PubMed: 35427251
DOI: 10.1097/WNO.0000000000001536 -
Seminars in Neurology Dec 2019Advances in ophthalmic diagnostics and results of interventional clinical trials are shifting diagnosis and management of idiopathic intracranial hypertension (IIH) to... (Review)
Review
Advances in ophthalmic diagnostics and results of interventional clinical trials are shifting diagnosis and management of idiopathic intracranial hypertension (IIH) to be more technology- and evidence-based. In this article, the evidence supporting current diagnostic criteria, evaluation, and medical and surgical management of IIH are reviewed.
Topics: Humans; Pseudotumor Cerebri
PubMed: 31847039
DOI: 10.1055/s-0039-1698744 -
Clinical Medicine (London, England) Sep 2020
Topics: Humans; Pseudotumor Cerebri
PubMed: 32934058
DOI: 10.7861/clinmed.Let.20.5.6 -
Journal of Neuro-ophthalmology : the... Dec 2018Traditional risk factors associated with idiopathic intracranial hypertension (IIH) include obesity, weight gain, and female sex. The incidence of IIH is increasing and... (Review)
Review
BACKGROUND
Traditional risk factors associated with idiopathic intracranial hypertension (IIH) include obesity, weight gain, and female sex. The incidence of IIH is increasing and yet the underlying trigger and the fueling pathological mechanisms are still poorly understood.
EVIDENCE ACQUISITION
Review of ophthalmology, neurology, general surgery, obesity, endocrinology, nutrition, and neurosurgery literature was made.
RESULTS
The facts that implicate sex and obesity in IIH and headache are examined. The role of fat distribution in IIH is questioned, and the concept of adipose tissue functioning as an endocrine organ driving IIH is discussed. The impact of androgen metabolism in IIH is reviewed as is the emerging role of glucagon-like-peptide-1 analogues in modulating intracranial pressure. This introduces the concept of developing targeted disease-modifying therapeutic strategies for IIH.
CONCLUSIONS
This review will discuss the possible role of the adipose/gut/brain metabolism axis in IIH and speculate how this may impact the pathogenesis of IIH and therapeutic opportunities.
Topics: Adipose Tissue; Anti-Obesity Agents; Bariatric Surgery; Global Health; Humans; Incidence; Intracranial Pressure; Obesity; Prognosis; Pseudotumor Cerebri; Risk Factors
PubMed: 29985799
DOI: 10.1097/WNO.0000000000000684