Cerebrospinal fluid total protein in idiopathic intracranial hypertension

Berezovsky, Damian E.; Vasseneix, Caroline; Peragallo, Jason H.; Newman, Nancy J.; Biousse, Valérie

doi:10.1016/j.jns.2017.08.3264

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…The study showed that the presence of ANP, TVO, or very high opening CSF pressure during baseline assessment are not indicators of surgery and a big proportion of them underwent subsequent regressive course. These results are passing with the studies of Agarwal and colleagues 2017 [2] and Berezovsky and colleagues 2017 [14] who stated that ANP, TVO, and high CSF pressure are not predictors of poor visual outcome in IIH, but follow-up of cases is needed to diagnose progressive cases.…”

Section: Discussionmentioning

confidence: 80%

Neuro-ophthalmological biomarkers of visual outcome in newly diagnosed idiopathic intracranial hypertension

Bahnasy

El-Heneedy

Elhassanien

et al. 2019

Egypt J Neurol Psychiatry Neurosurg

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Background: Idiopathic intracranial hypertension (IIH) is a disorder of unidentified etiology characterized by raised intracranial pressure (ICP) without clinical, laboratory, or radiological evidence of intracranial pathology. The aim of this work was to determine the visual outcome in newly diagnosed IIH patients. Methods: The study included 68 IIH patients; 59 responded to medical treatment and nine needed lumboperitoneal shunting (LPS). Patients were submitted to papilledema grading using Frisén Scale, water CSF manometry, brain MRI/ MRV, mean deviation of visual field examination (MD-VFE), optic nerve sheath diameter (ONSD), average optic disc optical coherence tomography-retinal nerve fiber layer (OCT-RNFL) thickness, and pattern-reversal visual evoked potential (VEP). Results: Patients needed LPS showed statistically significant increase in baseline papilledema grade, MD-VFE, ONSD, average OCT-RNFL thickness, and P100 VEP latency. On the other hand, both studied groups showed statistically nonsignificant differences regarding the patients' ages and opening CSF pressure. Conclusion: Newly diagnosed IIH patients' evaluation must be based on multimodality neuro-ophthalmological assessment where papilledema grade, MD-VFE, and OCT-RNFL are valuable biomarkers of PVD while P100 VEP latency delay is a predictor of poor visual outcome and ONSD is an early indicator of elevated ICP regression after LPS surgery.

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Section: Discussionmentioning

confidence: 80%

Neuro-ophthalmological biomarkers of visual outcome in newly diagnosed idiopathic intracranial hypertension

Bahnasy

El-Heneedy

Elhassanien

et al. 2019

Egypt J Neurol Psychiatry Neurosurg

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“…We suppose that the slight change in CSF total protein and Qalb is caused by repeated lumbar punctures and/or intrathecal administration of the drug and is not further influenced by the investigated clinical characteristics. Data on CSF findings in repeated lumbar punctures are difficult to compare because they are usually gathered in patients with other (CSF) pathologies (e.g., idiopathic intracranial hypertension) (36). It is possible that CSF flow slows down under therapy, but if there is a relation to the development of hydrocephalus (37) cannot be answered with our study.…”

Section: Discussionmentioning

confidence: 99%

Routine Cerebrospinal Fluid (CSF) Parameters in Patients With Spinal Muscular Atrophy (SMA) Treated With Nusinersen

et al. 2019

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Background: Nusinersen is an antisense-oligonucleotide (ASO) approved for treatment of 5q-spinal muscular atrophy (SMA). Since the drug cannot cross the blood-brain barrier (BBB), it must be administered into the cerebrospinal fluid (CSF) space repeatedly by lumbar puncture. However, little is known whether ASOs have an impact on CSF routine parameters that may yield information on CSF flow and/or intrathecal inflammation. The objective of this study was to examine CSF routine parameters in SMA patients treated with nusinersen.Methods: Routine CSF parameters [white cell count, total protein, CSF/serum quotients of albumin (Qalb), lactate, and oligoclonal IgG bands (OCB)] of 60 SMA patients (type 1, 2, and 3, aged 7–60 years) were retrospectively analyzed.Results: White cells ranged from 0 to 4/μL in CSF; a singular case of pleocytosis (8/μL) was observed in a patient in parallel with a systemic infection. Total protein and Qalb showed a mild increase from baseline to the following lumbar punctures (except for total protein in CSF at the fourth injection of nusinersen). Lactate levels revealed a stable course. In one patient, positive OCB in CSF were transiently observed. The slight change in total CSF protein and Qalb may be caused by repeated lumbar puncture and/or intrathecal administration of the drug.Conclusion: Our data suggest that a regular examination of routine CSF parameters in patients in which intrathecal ASOs are administered is important to obtain information on possible side effects and to gain further insights into intrathecal processes.

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“…One study showed that an increase of 1 cm in CSF opening pressure was associated with a small but statistically significant decrease in CSF total protein (-0.18 mg/dL). 14 . In the same study a multivariable analysis showed that increased CSF opening pressure and CSF total protein were independently associated with visual findings.…”

Section: Routine Csf Evaluationmentioning

confidence: 99%

Cerebrospinal fluid (CSF) and idiopatic intracranial hypertension (IIH): a critical review

Domingues

Vega²,

Brunale³

et al. 2022

Headache Med

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Pseudotumor cerebri is a syndrome that results from increased intracranial pressure. The main symptoms are headache, vision disturbances, and pulsatile tinnitus. Definitive diagnosis requires the presence of clinical and/or radiological signs of intracranial hypertension, high opening pressure on lumbar puncture (LP), and normal CSF constitution. Several studies have evaluated new contributions of CSF in the clinical evaluation and the in understanding of the pathophysiology of pseudotumor cerebri. Such studies have included the analysis of inflammatory biomarkers, adipokines, proteomic analysis, and CSF flow studies. In this review, we present the main results obtained so far and critically discuss the present status and the potential role of research involving the CSF in this condition. Based on current knowledge, it is possible to conclude that CSF research with new biomarkers has not yet provided information that can be employed in clinical practice at this moment. However, a better understanding of the constitution and dynamics of CSF circulation in patients with pseudotumor cerebri has brought some information about this condition and can potentially improve our knowledge about this condition in the future.

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Cerebrospinal fluid total protein in idiopathic intracranial hypertension

Cited by 9 publications

References 20 publications

Neuro-ophthalmological biomarkers of visual outcome in newly diagnosed idiopathic intracranial hypertension

Neuro-ophthalmological biomarkers of visual outcome in newly diagnosed idiopathic intracranial hypertension

Routine Cerebrospinal Fluid (CSF) Parameters in Patients With Spinal Muscular Atrophy (SMA) Treated With Nusinersen

Cerebrospinal fluid (CSF) and idiopatic intracranial hypertension (IIH): a critical review

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