Table 1

Questions formulated by the ABN IIH SIG on the diagnosis and management of IIH

Question number
Diagnostic principles
1 How should papilloedema be investigated?
Management principles
Principle one: treat the underlying disease
2 What is the best way to modify the underlying disease to induce remission?
Principle two: protect the vision
3 How should IIH be treated when there is imminent risk of visual loss?
4 What is currently the best surgical procedure for visual loss in IIH?
5 What other surgical procedures are performed for visual loss in IIH?
6 What is the current role of neurovascular stenting in acute IIH to prevent loss of vision?
7 What is the role of serial lumbar punctures in IIH?
8 What is the best drug treatment for IIH symptoms?
9 How should acetazolamide be prescribed?
10 Are there other drugs that are helpful in IIH?
Principle three: manage the headache
11 What is the best way to manage headaches in newly diagnosed IIH? (figure 4)
12 What is the best approach to long-term headache management in IIH?
13 What therapeutic strategies are useful for headache in IIH?
14 How should medication overuse headache be approached?
15 Should CSF diversion surgery be used in patients with IIH with headache alone?
16 Should neurovascular stenting be used in patients with IIH with headache alone?
17 How should an acute exacerbation of headache be investigated in those who are already shunted?
18 How should an acute exacerbation of headache be treated in those who are already shunted?
Clinical care and managing IIH in pregnancy
19 Are there any other chronic problems that need to be addressed in IIH?
20 What advice should be given regarding drug treatments in the pregnant patient with IIH?
21 What additional considerations for management are there in the pregnant patient with IIH?
IIHWOP
22 How should IIHWOP be managed?
Follow-up and monitoring of IIH
23 How should we follow-up and monitor these patients?
  • ABN, Association of British Neurologists; CSF, cerebrospinal fluid; IIH, idiopathic intracranial hypertension; IIHWOP, IIH without papilloedema; SIG, specialist interest group.