Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham.
Department of Neurology, University Hospitals Birmingham.
Curr Opin Neurol. 2019 Jun;32(3):422-431. doi: 10.1097/WCO.0000000000000690.
The current article appraises the recent developments in idiopathic intracranial hypertension (IIH), with particular attention to novel therapeutic avenues and advanced clinical assessment and monitoring with optical coherence tomography and telemetric intracranial pressure devices.
The incidence of IIH is increasing. The first consensus guidelines for IIH have been published detailing investigation and management algorithms for adult IIH. Improved understanding, clinical assessment and monitoring are emerging with the use of optical coherence tomography. Intracranial pressure telemetry is providing unique insights into the physiology of raised intracranial pressure in IIH. There are now an increasing number of ongoing clinical trials evaluating weight loss methods and novel targeted therapies, such as 11ß-HSD1 inhibition and Glucagon-like peptide 1 (GLP-1) receptor agonists.
Several studies are evaluating new therapies for IIH. Monitoring techniques are advancing, aiding diagnosis and allowing the clinician to accurately evaluate changes in papilloedema and intracranial pressure.
本文评价了特发性颅内高压(IIH)的最新进展,特别关注新的治疗途径以及使用光学相干断层扫描和遥测颅内压设备进行的先进临床评估和监测。
IIH 的发病率正在增加。已经发表了第一份 IIH 的共识指南,详细说明了成人 IIH 的检查和管理算法。随着光学相干断层扫描的使用,对 IIH 的理解、临床评估和监测正在得到改善。颅内压遥测技术为 IIH 中颅内压升高的生理学提供了独特的见解。现在有越来越多的正在进行的临床试验评估减肥方法和新的靶向治疗,如 11ß-HSD1 抑制和胰高血糖素样肽 1(GLP-1)受体激动剂。
几项研究正在评估 IIH 的新疗法。监测技术正在不断发展,有助于诊断,并使临床医生能够准确评估视乳头水肿和颅内压的变化。