neurologic disorders
Idiopathic Intracranial Hypertension
Treatment of Idiopathic Intracranial Hypertension
Acetazolamideortopiramate Weight loss if needed Medications used to prevent migraines, especiallytopiramate Sometimes surgery Idiopathic intracranial hypertension occasionally resolves without treatment. Treatment of idiopathic intracranial hypertension is aimed at the following: Reducing pressure Preserving vision Relieving symptoms The carbonic anhydrase inhibitoracetazolamide(250 mg orally 4 times a day) ortopiramate(which also inhibits carbonic anhydrase) up to 200 mg twice a day is used.Acetazolamidereduces cerebrospinal fluid production.Topiramatecan help patients lose weight, help lower intracranial pressure, and may relieve headache. Treatment may relieve headache. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used as needed. Patients with obesity are encouraged to lose weight, which may help reduce intracranial pressure. Serial lumbar punctures are controversial but are sometimes used, particularly if, while waiting for definitive treatment, vision is threatened. Definitive treatment includes optic nerve sheath fenestration, shunting, and venous sinus stenting. Any potential causes (disorders, drugs, or medications) are corrected or eliminated if possible. Frequent ophthalmologic assessment (including quantitative visual fields) is required to monitor response to treatment; testing visual acuity is not sensitive enough to warn of impending vision loss. If vision deteriorates despite treatment, one of the following may be indicated: Optic nerve sheath fenestration Shunting (lumboperitoneal or ventriculoperitoneal) Endovascular venous stenting Metabolic and Bariatric Surgery with sustained weight loss may cure the disorder in patients who have obesity and were otherwise unable to lose weight. 