IIH most commonly affects women, particularly overweight women between ages 15 and 45. However, the disorder is not limited to women, and can affect people of all ages and races, both male and female, of all shapes and sizes. It is estimated there are about 12,000 people living in the United States with this disease. The cardinal sign of IIH is papilledema (swelling of the optic nerves), although some atypical patients may not have papilledema. Occasionally patients may present with abducens or other cranial nerve palsies. Symptoms can include severe headache, pulsatile tinnitus, visual disturbances (e.g. diplopia), nausea/vomiting, etc. Most serious is the potential for permanent loss of vision or even blindness. IIH is treated mainly through the attempted reduction of CSF pressure and, where applicable, weight loss.[1] The treatment of increased ICP of a known origin (SIH) consists of removing the inciting cause, if possible, and attempting to reduce CSF pressure. IIH may resolve after initial treatment, may go into remission and relapse, or may continue chronically. CSF pressure may be temporarily decreased by repeated spinal taps (to remove excessive cerebrospinal fluid). The standard treatment of IIH includes drugs that reduce cerebrospinal fluid production- most notably acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor, meaning it inhibits an enzyme that is key to the production of certain fluids, including CSF. Sold under the brand name Diamox, it is the most common drug used in treatment of IIH. Other drugs such as furosemide and various diuretics, topiramate and prednisone may be used in an attempt to reduce ICP.
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