Neurosurgery Blog: Headache Characteristics at Baseline in the Idiopathic Intracranial Hypertension Treatment Trial (S41.006)

Monday, April 21, 2014

Headache Characteristics at Baseline in the Idiopathic Intracranial Hypertension Treatment Trial (S41.006)

Neurology recent issues

OBJECTIVE:To report the headache features of subjects enrolled in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT)BACKGROUND:The IIHTT is a multicenter, randomized, double-masked, placebo controlled trial comparing acetazolamide to matching placebo in subjects with mild visual loss from IIH. A low-sodium diet and weight loss program was offered to all subjects. 165 subjects (161 women, 4 men) were enrolled.DESIGN/METHODS:Headache characteristics were queried at baseline and throughout the duration of the study during structured interviews. Descriptive statistics, Spearman and Pearson correlation coefficients were applied.RESULTS:Headache was the most common symptom (n=139, 84%) and was the initial symptom in 35%. The average severity on a 1-10 scale was 6.3 1.9 with 9 subjects reporting a severity of 10. 32% of subjects with headache described constant pain. Subjects with intermittent headache experienced a median of 12 headache days monthly (range 1-30). The pain was characterized as pressure (47%), throbbing/pounding (42%), stabbing (5%), exploding (2%) or other (4%), and 42% experienced nocturnal awakening. The location of head pain was frontal (68%), global (36%), posterior (39%), unilateral (30%), ocular (47%) and extended to the neck in 47%. Associated symptoms included photophobia (70% ), phonophobia (52%), nausea (47%), vomiting (17%), and aggravation by routine physical activity (50%). 41% of participants reported a history of migraine (18% with aura, 58% without aura, 24% both). The average HIT-6 score was 59.7 9.0 (severe disability). There was no correlation between the HIT-6 score and papilledema grade, perimetric mean deviation, opening pressure or body mass index (BMI).CONCLUSIONS:The headache pain of IIH in this cohort was variable in quality and location, and many subjects had associated symptoms that are typical of migraine. The headaches were severe, disabling and not related to visual status, BMI, opening pressure or papilledema grade.Study Supported by: National Eye Institute

Disclosure: Dr. Friedman has received personal compensation for activities with MAP Pharmaceuticals, Zogenix, and Allergan. Dr. Friedman has received personal compensation in an editorial capacity for Neurology Reviews and Medlink Neurology. Dr. Friedman's institution has received research support from Merck & Co., Inc., Electocore, and the National Eye Institute.

Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/S41.006?rss=1