Journal article
CSF pressure, papilledema grade, and response to acetazolamide in the Idiopathic Intracranial Hypertension Treatment Trial
Journal of neurology, Vol.262(10), pp.2271-2274
10/2015
DOI: 10.1007/s00415-015-7838-9
PMID: 26159101
Abstract
Previous reports suggest an association between the degree of optic nerve head edema and CSF pressure (CSFp) in idiopathic intracranial hypertension (IIH). We hypothesized that CSFp would be associated with Frisén papilledema grade (FPG) and other clinical features, and that FPG would modify the CSFp response to acetazolamide in participants in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). In the IIHTT, eligible patients underwent lumbar puncture (LP) prior to enrollment and were randomly assigned to one of two treatment groups: acetazolamide plus supervised diet or placebo plus supervised diet. Trial eligibility required baseline CSFp ≥250 mm H2O or ≥200 mm H2O with compelling clinical or imaging IIH findings. Associations between CSFp and FPG and other clinical features were examined at baseline. The effect of acetazolamide on 6-month change in CSFp was examined in those with low FPG (grades I-III) and those with high FPG (grades IV-V) at baseline. All 165 enrolled subjects had a baseline LP and 85 had an LP at 6 months. There was an association between CSFp and FPG at baseline: CSFp was more elevated in subjects with high FPG (378 ± 90 mm H2O, n = 50) than in subjects with low FPG (331 ± 77, n = 115, p = 0.002). At 6 months, acetazolamide had a similar effect on CSFp in subjects with high FPG (-79.9 mm H2O) and in subjects with low FPG (-50.9 mm H2O, p = 0.50). We found a modest association between CSFp and FPG. Acetazolamide had a beneficial effect on CSFp regardless of baseline FPG.
Details
- Title: Subtitle
- CSF pressure, papilledema grade, and response to acetazolamide in the Idiopathic Intracranial Hypertension Treatment Trial
- Creators
- Jorge C Kattah - Department of Neurology, Illinois Neurologic Institute and University of Illinois College of Medicine, 530 North Glen Oak Avenue, Peoria, IL, 61637, USA. kattahj@uic.eduJohn H Pula - Department of Neurology at NorthShore University HealthSystem, Glenview, USALuis J Mejico - Department of Neurology, SUNY, Brooklyn, USAMichael P McDermott - Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, USAMark J Kupersmith - Department of Neurology, Roosevelt Hospital/NYEEI, New York, USAMichael Wall - Department of Neurology and Ophthalmology, University of Iowa, Iowa City, USA
- Resource Type
- Journal article
- Publication Details
- Journal of neurology, Vol.262(10), pp.2271-2274
- Publisher
- Germany
- DOI
- 10.1007/s00415-015-7838-9
- PMID
- 26159101
- ISSN
- 0340-5354
- eISSN
- 1432-1459
- Grant note
- U10 EY017281-01A1 / NEI NIH HHS U10 EY017387-01A1 / NEI NIH HHS
- Language
- English
- Date published
- 10/2015
- Academic Unit
- Neurology; Ophthalmology and Visual Sciences
- Record Identifier
- 9983979953702771
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