Different Characteristics of Pre-Pubertal and Post-Pubertal Idiopathic Intracranial Hypertension: A Narrative Review

Lyons, Hannah; Mollan, Sophie L. P.; Liu, Grant T.; Bowman, Richard; Thaller, Mark; Sinclair, Alexandra J; Mollan, Susan P

doi:10.1080/01658107.2022.2153874

Cited by 14 publications

(10 citation statements)

References 95 publications

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“… 35 , 49 There have been detailed discussions on the threshold for the diagnosis of in both adults and children. 24 , 35 , 50 In the United Kingdom, consensus amongst neurologists, neuro-ophthalmologists and neurosurgeons who manage idiopathic intracranial hypertension suggest a “grey zone” between an opening pressure of 25 and 30cmH 2 0, and with an increased opening pressure pathology more likely. 24 A further factor for those living with obesity and idiopathic intracranial hypertension is the influence of body mass index, where it is well documented that the CSF pressure has been found to be increased with body mass index.…”

Section: Resultsmentioning

confidence: 99%

A Neuro-Ophthalmologist’s Guide to Advances in Intracranial Pressure Measurements

Mollan,

Momin,

Khatkar

et al. 2023

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Cerebrospinal fluid disorders have a wide-ranging impact on vision, headache, cognition and a person’s quality of life. Due to advances in technology and accessibility, intracranial pressure measurement and monitoring, usually managed by neurosurgeons, are being employed more widely in clinical practice. These developments are of direct importance for Ophthalmologists and Neurologists because the ability to readily measure intracranial pressure can aide management decisions. The aim of this review is to present the emerging evidence for intracranial pressure measurement methods and interpretation that is relevant to Neuro-ophthalmologists.

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Section: Resultsmentioning

confidence: 99%

A Neuro-Ophthalmologist’s Guide to Advances in Intracranial Pressure Measurements

Mollan,

Momin,

Khatkar

et al. 2023

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“…This was demonstrated in one study where incidence in women was highest in the 20- to 29-year age group (16.5 per 100 000 person-years) followed by the 13- to 19-year age group (8.7 per 100 000 person-years) and the 30- to 39-year age group (8.4 per 100 000 person-years) (3). IIH following onset of puberty has the same phenotype as the adult condition (32,50) Available treatment options are limited as there has been no prior RCT that has enrolled adolescents. It is therefore important to offer these patients access to novel treatment strategies but also to allow for adapted clinical trial rules, as for orphan diseases. Of note, in the European Union extrapolation of data from adult trials can be used as evidence for licensing of medicines in adolescents (51).…”

Section: Previous Trials In Iihmentioning

confidence: 99%

“…IIH following onset of puberty has the same phenotype as the adult condition (32,50) Available treatment options are limited as there has been no prior RCT that has enrolled adolescents. It is therefore important to offer these patients access to novel treatment strategies but also to allow for adapted clinical trial rules, as for orphan diseases.…”

Section: Previous Trials In Iihmentioning

confidence: 99%

“…This guideline is designed to advance the quality of future IIH trials and will subsequently help improve finding meaningful treatments for people with IIH. Given that IIH is rarer in prepubertal children, and potentially has a different underlying pathogenesis (32), the present guidelines will primarily focus on those postpuberty and adults. The present guidelines will only address IIH and not secondary pseudotumor cerebri syndrome nor Idiopathic Intracranial Hypertension without Papilledema (IIHWOP) as these are rare conditions with likely alternative underlying pathophysiology (33)(34)(35).…”

Section: Introductionmentioning

confidence: 99%

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Guidelines of the International Headache Society for Controlled Clinical Trials in Idiopathic Intracranial Hypertension

Mollan,

Fraser,

Digre

et al. 2023

Cephalalgia

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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 Guidelines for Controlled Clinical Trials in Idiopathic Intracranial Hypertension aims to establish guidelines for designing state-of-the-art controlled clinical trials for idiopathic intracranial hypertension.

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“…8 The precise prevalence of asymptomatic IIH is unclear from the literature. Children appear to have fewer symptoms than adults 9,10 but the previous literature has been based on small case series or case reports. Additionally, asymptomatic patients at baseline may not remain asymptomatic.…”

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confidence: 99%

Asymptomatic idiopathic intracranial hypertension: Prevalence and prognosis

Thaller

Homer

Mollan

et al. 2023

Clinical Exper Ophthalmology

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BackgroundLittle is known about the presentation and prognosis of asymptomatic idiopathic intracranial hypertension (IIH). Papilloedema can be found incidentally on routine fundus examination, with many of these patients actually having symptoms on direct questioning. The aim was to evaluate visual and headache outcomes in people with IIH who present with or without symptoms.MethodsProspective observational cohort study, between 2012 and 2021, 343 people with confirmed IIH diagnosis were enrolled in the IIH:Life database. Outcomes such as vision (LogMAR); Humphrey visual field perimetric mean deviation (PMD) and optical coherence tomography (OCT) and headache were evaluated using LOESS (locally weighted scatterplot smoothing) graphs and regression analysis.ResultsOne hundred and twenty‐one people had incidentally found papilloedema, with 36 people with completely asymptomatic presentations. Those with asymptomatic IIH at diagnosis had similar visual prognosis compared to those with symptomatic disease. Sixty‐six percent of the asymptomatic cohort became symptomatic during follow‐up, and of these the predominant symptom was headache (96%). Headache frequency during follow‐up was lower in the asymptomatic cohort.ConclusionsThe prognosis of those with IIH who present with or without symptoms is similar.

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Different Characteristics of Pre-Pubertal and Post-Pubertal Idiopathic Intracranial Hypertension: A Narrative Review

Cited by 14 publications

References 95 publications

A Neuro-Ophthalmologist’s Guide to Advances in Intracranial Pressure Measurements

A Neuro-Ophthalmologist’s Guide to Advances in Intracranial Pressure Measurements

Guidelines of the International Headache Society for Controlled Clinical Trials in Idiopathic Intracranial Hypertension

Asymptomatic idiopathic intracranial hypertension: Prevalence and prognosis

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