title: [Characteristic neurological features, differential diagnostic criteria and medicinal treatment of idiopathic intracranial hypertension].
abstract: Persistent headache and loss of visual acuity combined with papilledema are the predominant symptoms of idiopathic intracranial hypertension (IIH). The clinical signs are not different from those seen in other diseases with elevated intracranial pressure. To differentiate primary and secondary forms of increased intracranial pressure neuroimaging procedures and analysis of cerebrospinal fluid (CSF) are absolutely essential according to national and international guidelines. Lumbar puncture reveals an elevated opening pressure in cases of IIH as the only pathological finding. Treatment options are serial lumbar punctures combined with body weight reduction as well as medication with carbonic anhydrase inhibitors, such as acetazolamide and topiramate or diuretic therapy with furosemide. In some patients surgical options, e.g. optic nerve sheath fenestration, CSF shunting procedures including ventriculoperitoneal and lumboperitoneal shunt systems and bariatric surgery also have to be considered. In recent years modern neuroradiological procedures have also been applied (e.g. venous stenting in cases of sinus obstruction) in some centers.
authors.affiliation: Klinik für Neurologie und Neurologische Frührehabilitation, Klinikum Duisburg GmbH, Zu den Rehwiesen 9, 47053, Duisburg, Deutschland. klaus-dieter.willenborg@sana.de.
authors.forename: K-D
authors.initials: KD
authors.lastname: Willenborg
authors.affiliation: Klinik für Neurologie und Neurologische Frührehabilitation, Klinikum Duisburg GmbH, Zu den Rehwiesen 9, 47053, Duisburg, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Nacimiento
mesh_terms: D000086:Acetazolamide / Q000627:therapeutic use; D002557:Cerebrospinal Fluid Shunts; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D005665:Furosemide / Q000627:therapeutic use; D019983:Guideline Adherence; D020773:Headache Disorders / Q000209:etiology; D009460:Neurologic Examination; D011559:Pseudotumor Cerebri / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D013129:Spinal Puncture; D000077236:Topiramate; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity; D015431:Weight Loss
chemical_list: D000077236:Topiramate; D005632:Fructose; D005665:Furosemide; D000086:Acetazolamide
keywords: Diagnostics; Headache; Idiopathic intracranial hypertension; Loss of visual acuity; Therapy