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Current and emerging diagnostic and management approaches for idiopathic intracranial hypertension

Ravi Piccus1, Mark Thaller2,3,4, Alexandra J Sinclair2,3,4

  • 1Medical school, University of Birmingham, Birmingham, UK.

Expert Review of Neurotherapeutics
|April 28, 2023
PubMed

Insights

Idiopathic intracranial hypertension (IIH) is increasingly linked to obesity and metabolic dysfunction. Emerging evidence suggests IIH is a systemic metabolic disease, necessitating broader treatment approaches beyond eye-focused management.

Area of Science:

  • Neurology
  • Metabolic Disorders
  • Ophthalmology

Background:

  • Idiopathic intracranial hypertension (IIH) presents with elevated intracranial pressure, causing severe headaches and potential vision loss.
  • The condition's incidence and prevalence correlate with obesity rates, yet no approved treatments exist.
  • Current management primarily targets papilledema, overlooking potential systemic aspects.

Approach:

  • This review explores emerging pathophysiological evidence for IIH.
  • It outlines diagnostic pathways and discusses current and potential therapeutic strategies.
  • The focus is on novel targeted therapeutics for IIH.

Key Points:

  • IIH exhibits metabolic dysregulation and systemic manifestations beyond obesity.
  • Future management must address debilitating headaches and associated systemic risks.
  • Systemic risks include preeclampsia, gestational diabetes, and major cardiovascular events.

Conclusions:

  • IIH is increasingly recognized as a systemic metabolic disease.
  • Management strategies need to evolve beyond ocular-centric approaches.
  • Targeted therapeutics addressing metabolic pathways are on the horizon.
Abstract

Keywords:
Bariatric surgeryglucagon like peptide 1headacheintracranial pressureoptical coherence tomographypapilledemapregnancyprognosis

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