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What’s the Difference Between IIH and Pseudotumor?

IIH is only one of multiple conditions that may lead to pseudotumor cerebri

It is important to understand that IIH is only one of multiple conditions that may lead to pseudotumor cerebri. Thus, some cases of pseudotumor are truly without an identifiable cause (hence the term idiopathic in IIH). However, in other cases, patients may meet the diagnostic criteria of pseudotumor but have a known association (such a medical condition or use of a medication) with a pseudotumor cerebri diagnosis. In these cases, depending on the condition or medication, treatment of the medical condition or removal of the medication may improve the patient’s symptoms.

Known as the modified Dandy criteria, the diagnostic criteria for IIH was revised in 1985, from its original version in the 1930s. Four fundamental features are required to establish the diagnosis of IIH:

Symptoms consistent with increased intracranial pressure: headaches, vomiting, and nausea. Visual signs and symptoms such as blurriness, transient obscurations of vision, and papilledema.

  1. Normal neurological exam with the exception of unilateral or bilateral cranial VI nerve paresis.
  2. Elevated opening pressure on lumbar puncture (greater than 250 mm) and normal analysis of cerebrospinal fluid.
  3. Normal imaging of the brain.₁
  1. https://n.neurology.org/content/59/10/1492

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