Idiopathic intracranial hypertension (IIH), previously known as pseudotumor cerebri, is is a condition where the pressure around the brain (intracranial pressure) is elevated without a specific cause. This results in swelling of the optic nerves. It mainly occurs in young women who are obese or overweight. It may be associated with the use of specific medications such as antibiotics (tetracycline, minocycline) or high doses of vitamin A.
Patients with IIH may have symptoms such as headache, blurry vision with changes in body position, a sensation of hearing their heartbeat in their ears, or blurry or double vision. Often patients do not have any symptoms and are incidentally found to have swollen optic nerves on an eye examination. When the optic nerves are swollen, patients are at risk for permanent vision loss.
To diagnose IIH, an MRI of the brain and lumbar puncture are required. This ensures that there is not another reason for the intracranial pressure to be elevated such as a brain tumor or blood clot.
The best treatment for IIH is weight loss. Even a small amount of weight loss can have a significant impact on the signs and symptoms of the condition. A medication called acetazolamide (Diamox) is frequently used to treat IIH. This medication often causes a tingling feeling in the fingers and toes and a metal taste in the mouth. These sensations typically decrease with time.
IIH may cause significant vision loss. If this is the case, a surgical procedure such as a shunt or optic nerve sheath fenestration will be recommended.
It is important that patients with IIH have regular eye examinations with a neuro-ophthalmologist since peripheral vision is affected first. Patients often do not recognize decreased peripheral vision until it is too late and the vision loss is irreversible.
Read more about IIH on the National Eye Institute website .