The annual incidence of idiopathic intracranial hypertension (IIH) has increased from 1.0 per 100000 (1990–2001) to 2.4 per 100000 (2002–2014). Strong correlation exists with rising levels of obesity. We conducted an audit within East Kent Hospitals NHS Trust utilising the 2018 ABN guidelines. A retrospective analysis was performed on 33 patients diagnosed with IIH, from September 2017 to September 2018.
The results demonstrated that all patients had CSF opening pressure recorded. However, only 42% had MRI brain and 24% had MR-venogram within 24 hours, while just 27% completed all neuroimaging within 48 hours. Formal visual field testing at identification of papilloedema was performed in 27% and ongoing ophthalmology assessment was arranged in 82%. BMI was recorded in only 3% and weight management discussion was recorded in 27%. Headache management was initiated in 91%. Discussion regarding drug side effects (e.g. Acetazolamide and Topiramate) were documented in just 15% and teratogenicity in 3%.
These findings demonstrate clear areas for improvement. Working alongside acute physicians and ophthalmologists to formalise neuroimaging pathways and visual field assessments is paramount. Information leaflets including drug side effects and teratogenicity, as well as weight loss advice, should be given at diagnosis. BMI should be recorded at each appointment.
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