title: Headache determines quality of life in idiopathic intracranial hypertension.
abstract: BACKGROUND
  The effect of idiopathic intracranial hypertension (IIH) on quality of life (QOL) is poorly understood. Our objectives were to compare QOL in IIH to the normal UK population; to investigate QOL changes with treatment of IIH, using a weight loss intervention, and to determine which clinical factors influence QOL.
  
  
  METHODS
  This was a prospective cohort evaluation of QOL, using the 36-Item Short Form (SF-36) Health Survey questionnaire, before and after a therapeutic dietary intervention which resulted in significant reduction in body mass index (BMI), intracranial pressure (ICP), papilloedema, visual acuity, perimetric mean deviation (Humphrey 24-2) and headache (six-item headache impact test (HIT-6) and headache diary). Baseline QOL was compared to an age and gender matched population. The relationship between each clinical outcome and change in QOL was evaluated.
  
  
  RESULTS
  At baseline, QOL was significantly lower in IIH compared to an age and gender matched population in most domains, p < 0.001. Therapeutic weight loss led to a significant improvement in 10 out of 11 QOL domains in conjunction with the previously published data demonstrating significant improvement in papilloedema, visual acuity, perimetry and headache (p < 0.001) and large effect size. Despite significant improvement in clinical measures only headache correlated significantly (p < 0.001) with improving QOL domains.
  
  
  CONCLUSIONS
  QOL in IIH patients is significantly reduced. It improved with weight loss alongside significant improvement in clinical measures and headache. However, headache was the only clinical outcome that correlated with enhanced QOL. Effective headache management is required to improve QOL in IIH.
authors.affiliation: Neurosciences, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Vincent Drive, Birmingham, B15 2TT, UK, YXM075@bham.ac.uk.
authors.forename: Yasmeen
authors.initials: Y
authors.lastname: Mulla
authors.forename: Keira A
authors.initials: KA
authors.lastname: Markey
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Woolley
authors.forename: Smitaa
authors.initials: S
authors.lastname: Patel
authors.forename: Susan P
authors.initials: SP
authors.lastname: Mollan
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Sinclair
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006261:Headache / Q000150:complications* / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011559:Pseudotumor Cerebri / Q000150:complications* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult