Treatment of idiopathic intracranial hypertension: Is there a place for octreotide?

Deftereos, Spyros; Panagopoulos, Gregory; Georgonikou, D; Karageorgiou, Clementine; Karageorgiou, Elissaios; G, Piadites

doi:10.1177/0333102411424211

Cited by 16 publications

(12 citation statements)

References 5 publications

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“…Presumed mechanisms of action of topiramate in IIH were a combination of weight reduction as well as reduction of CSF formation. 57 A small study 58 suggested that octreotide, a potent inhibitor of growth hormone and insulin-like growth factor 1, might reduce the ICP in IIH patient. Although this drug is not routinely used in IIH, it might represent a promising area of research.…”

Section: Treatment Of Iihmentioning

confidence: 99%

Update on the pathophysiology and management of idiopathic intracranial hypertension

Biousse

Bruce

Newman

2012

J Neurol Neurosurg Psychiatry

240

164

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Idiopathic Intracranial Hypertension (IIH) is a disease of unknown etiology typically affecting young, obese women, producing a syndrome of increased intracranial pressure without identifiable cause. Despite a large number of hypotheses and publications over the past decade, the etiology is still unknown. Vitamin A metabolism, adipose tissue as an actively secreting endocrine tissue, and cerebral venous abnormalities are areas of active study regarding IIH’s pathophysiology. There continues to be no evidence-based consensus or formal guidelines regarding management and treatment of the disease. Treatment studies show that the diagnostic lumbar puncture is a valuable intervention beyond its diagnostic importance, and that weight management is critical. However, open questions remain regarding the efficacy of acetazolamide, cerebrospinal fluid shunting procedures, and cerebral transverse venous sinus stenting.

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Section: Treatment Of Iihmentioning

confidence: 99%

Update on the pathophysiology and management of idiopathic intracranial hypertension

Biousse

Bruce

Newman

2012

J Neurol Neurosurg Psychiatry

240

164

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“…Octreotide has been used in an uncontrolled open-label prospective study and the authors have reported that octreotide might be a promising therapeutic option for IIH. However, they have also expressed their questions which have remained to be answered in further clinical trials including the optimal treatment duration, the efficacy and safety of this drug in IIH [5].…”

Section: Discussionmentioning

confidence: 99%

Ventriculoperitoneal shunt treatment in a pregnant renal transplant recipient with idiopathic intracranial hypertension: Case report and review of the literature

Doğan

Göksu

et al. 2018

Neurologia i Neurochirurgia Polska

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Idiopathic intracranial hypertension (IIH) is a relatively uncommon disorder characterised by raised intracranial pressure without an established pathogenesis. Diagnosis of IIH requires the demonstration of symptoms and signs referable only to elevated intracranial pressure; cerebrospinal fluid (CSF) opening pressure >25cm HO measured in the lateral decubitus position; normal CSF composition; and no evidence for an underlying structural cause demonstrated by using MRI or contrast-enhanced CT scan for typical patients and MRI and MR venography for atypical patients such as man, children and those with low body mass index. We present a 38-year old primigravid renal transplant patient at 7 weeks of gestation who presented with 2 weeks of intense, throbbing, holocranial headache, nausea, vomiting, photophobia, diplopia and progressive visual loss. When medical treatment fails and/or not appropriate to use due to the reported of teratogenic risks in pregnant women, surgical interventions gain importance. In this particular patient, venticuloperitoneal shunt was chosen as the CSF diversion technique. In this case report indications, contraindications in addition to outcomes regarding headache, vision loss and the resolution of papilloedema of the present surgery options for IIH are discussed.

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“…This drug is a long-acting, synthetic somatostatin analog that also inhibits the effect of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Existing data suggest that octreotide could considerably improve papilledema and the associated visual deficits as well as the headache [89][90][91][92]. Its efficacy thereby extends far beyond its known analgesic effect [93].…”

Section: Pharmaceutical Treatmentmentioning

confidence: 99%

Update on Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)

Hoffmann

May

2017

Neurology International Open

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Idiopathic intracranial hypertension is characterized by an increase of intracranial pressure of unknown etiology. The clinical presentation is dominated by progressive visual disturbances, which are commonly the result of a papilledema, headache and cranial nerve palsies. Clinical studies have revealed over the past years that the syndrome may also be associated with olfactory disturbances, cognitive deficits and a pulsatile tinnitus.The underlying pathomechanism is probably based on a disturbance of venous outflow, which causes a reduced absorption of cerebrospinal fluid that results in an increase of cerebrospinal fluid pressure. It remains unclear if the venous outflow disturbance results from the overweight-induced increase of intrathoracic pressure, the presence of sinus vein stenoses or both conditions. Recently hormonal factors have also been discussed, but the mechanisms behind a potential influence on intracranial pressure remain unclear.Treatment of idiopathic intracranial hypertension relies mainly on an effective body weight reduction and medication with carboanhydrase inhibitors, which can reduce the production of cerebrospinal fluid and body weight. Results of the first randomized, placebo-controlled trial as well as a 12-month follow-up show that acetazolamide effectively reduces papilledema, visual disturbances and headache in idiopathic intracranial hypertension. In contrast, the evidence for the carboanhydrase inhibitors topiramate and furosemide still relies on open-label trials, because double-blind, placebo-controlled trials for their efficacy in idiopathic intracranial hypertension do not exist. In addition to the treatment with carboanhydrase inhibitors, increasing evidence suggests that the somatostatin analog octreotide may be effective in the treatment of idiopathic intracranial hypertension, but to date no randomized, double-blind, placebo-controlled trials exist to confirm this observation.

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Treatment of idiopathic intracranial hypertension: Is there a place for octreotide?

Cited by 16 publications

References 5 publications

Update on the pathophysiology and management of idiopathic intracranial hypertension

Update on the pathophysiology and management of idiopathic intracranial hypertension

Ventriculoperitoneal shunt treatment in a pregnant renal transplant recipient with idiopathic intracranial hypertension: Case report and review of the literature

Update on Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)

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