PO059 An audit of the management of idiopathic intracranial hypertension

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Abstract

Introduction

Idiopathic intracranial hypertension (IIH) is a headache disorder that can result in irreversible blindness. Currently there are no published guidelines on the management of IIH. The aim of this audit is to determine whether patients presenting to Frimley Park Hospital (FPH) with IIH are adequately assessed and treated, based upon evidence from published clinical trials.

Methods

Patients presenting to FPH with a new diagnosis or relapse of chronic IIH between 01/01/2013 and 31/12/2015 were identified using coding. Data was collected retrospectively from healthcare records.

Results

20 patients were audited. 14 were new diagnoses. Diagnosis was confirmed in all patients by fundoscopy, MRI brain and lumbar puncture (LP). 86% had visual acuity recorded at presentation. 72% patients reported partial symptom improvement with weight loss, 37% reported benefit with acetazolamide. 79% underwent more than one LP but response reduced with successive procedures. No patient requiring >3 LP’s achieved complete remission. 3 patients underwent CVS stenting.

Conclusion

Early follow up may help identify patients who are unlikely to achieve complete remission with medical therapy alone. The role of early aggressive repeat LP needs prospective evaluation given that remission seems to be achieved. Guidelines are needed to develop future standards of management.

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