Idiopathic Intracranial Hypertension Medication

  • Author: Mark S Gans, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jan 5, 2012
 

Medication Summary

The medications used in this disorder are directed at lowering intracranial pressure. The diuretic acetazolamide is the most effective drug for this task. Furosemide may be used as a replacement, although it is not as potent as acetazolamide. Corticosteroids are indicated on a short-term basis in patients who present with severe papilledema and compromise of their visual function.

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Carbonic anhydrase inhibitors

Class Summary

Carbonic anhydrase (CA) is an enzyme found in many tissues. Catalyzes a reversible reaction where carbon dioxide becomes hydrated and carbonic acid becomes dehydrated. These changes may result in a decrease in cerebrospinal fluid by the choroid plexus.

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Acetazolamide (Diamox, Diamox Sequels)

 

Nonbacteriostatic sulfonamide; potent CA inhibitor, which is effective in diminishing fluid secretion. Lowers intracranial pressure by decreasing production of cerebrospinal fluid. Inhibition of CA results in a drop in sodium ion transport across the choroidal epithelium. Reduction of cerebrospinal fluid production occurs within hours.

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Loop diuretics

Class Summary

These agents inhibit reabsorption of sodium in the ascending limb of Henle loop and have a weak inhibitory action on carbonic anhydrase.

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Furosemide (Lasix)

 

Unclear how it inhibits cerebrospinal fluid production. A combination of CA inhibition and effect on sodium absorption across the choroid plexus may result in the decrease of cerebrospinal fluid production.

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Contributor Information and Disclosures
Author

Mark S Gans, MD  Associate Professor, Director of Neuro-Ophthalmology, Department of Ophthalmology, McGill University; Clinical Director, Department of Ophthalmology, Adult Sites, McGill University Hospital Center, Interim Chairman of the Department of Ophthalmology, McGill University

Mark S Gans, MD is a member of the following medical societies: American Academy of Ophthalmology, Canadian Medical Association, Canadian Ophthalmological Society, and North American Neuro-Ophthalmology Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Edsel Ing, MD, FRCSC  Associate Professor, Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine; Consulting Staff, Toronto East General Hospital, Canada

Edsel Ing, MD, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Society of Ophthalmic Plastic and Reconstructive Surgery, Canadian Ophthalmological Society, North American Neuro-Ophthalmology Society, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Brian R Younge, MD  Professor of Ophthalmology, Mayo Clinic School of Medicine

Brian R Younge, MD is a member of the following medical societies: American Medical Association, American Ophthalmological Society, and North American Neuro-Ophthalmology Society

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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  19. Sinclair AJ, Kuruvath S, Sen D, et al. Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review. Cephalalgia. Dec 2011;31(16):1627-33. [Medline].

 
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