Original articleChanges in weight, papilledema, headache, visual field, and life status in response to diet and metformin in women with idiopathic intracranial hypertension with and without concurrent polycystic ovary syndrome or hyperinsulinemia
Section snippets
Patients
The Jewish Hospital Institutional Review Board approved this consecutive case study. Written informed consent was obtained from all women, and the study was carried out in accordance with the ethical standards for human experimentation established by the Declaration of Helsinki of 1975, revised in 1983.
Of 103 women in the previous studies on IIH,16, 17 36 met this study’s enrollment criteria,which included (1) a minimum of 6 months of follow-up on MET-diet combination or diet alone; (2)
Characteristics of patients and treatment groups
Overall, 34 women were Caucasian and 2 were African-American. Mean ± SD and median age was 35 ± 9 and 34 years, range 16 to 54 years. Mean ± SD and median BMI were 37.1 ± 6.1, and 37.0. As is common in IIH,2, 3, 13, 16, 17, 22 the cohort was predominantly obese27 and extremely obese.27 Overall, 20 women (56%) had a BMI ≥ 30 and < 40 (obese),27 13 (36%) had a BMI ≥ 40 (extremely obese),27 and 3 (8%) were overweight27 with a BMI ≥ 25 and < 30. The lowest BMI was 27.6, and the fifth and tenth
Discussion
As revealed in the current study, despite conventional7 therapy (acetazolamide, Topamax, furosemide), the signs and symptoms of IIH may persist over a mean follow-up of 10 to 11 months. This finding is congruent with previous studies of response of IIH to medical and surgical treatment.2, 3, 5, 7, 21, 24
As the cause(s) of IIH can be multifactorial 3, 9, 10, 11, 13, 16, 17, 18, 19, 20, 21, 28, 29, 55, 56, 57, 58, 59, 60, 61 or largely unknown,18 inadequate information exists regarding which
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A systematic review on idiopathic intracranial hypertension comorbid with polycystic ovarian syndrome and its consequences
2024, European Journal of Obstetrics and Gynecology and Reproductive BiologyImpaired cerebrospinal fluid pressure
2017, Handbook of Clinical NeurologyCitation Excerpt :Among the mechanisms discussed, hormonal factors have been suggested to underlie the association between obesity and IIH. Female preponderance, age of affected individuals, body fat distribution, and high comorbidity of polycystic ovarian syndrome (Glueck et al., 2006) support this hypothesis. Several hormones and mechanisms have been proposed but the results from clinical studies remain inconclusive.
Understanding idiopathic intracranial hypertension: Mechanisms, management, and future directions
2016, The Lancet NeurologyCitation Excerpt :Polycystic ovarian syndrome is a common endocrine disorder in women of childbearing age, affecting around 4–8% of women;61–63 44% of affected women are obese.61 64% of women with idiopathic intracranial hypertension have polycystic ovarian syndrome,64 which is characterised by hirsutism, menstrual irregularities, infertility, and hyperandrogenism. However, the precise relation between polycystic ovarian syndrome and idiopathic intracranial hypertension has yet to be established.64
Idiopathic intracranial hypertension: a step change in understanding the disease mechanisms
2023, Nature Reviews Neurology
Supported in part by a Jewish Hospital Medical Research Council Grant and by the Lipoprotein Research Fund of the Jewish Hospital, Cincinnati, Ohio.
This study followed a protocol approved by the Jewish Hospital Institutional Review Board, with signed informed consent.