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neurology ophthalmology

Idiopathic Intracranial Hypertension (IIH) Diagnostic Criteria

Applies modified Dandy criteria for diagnosis of IIH (pseudotumour cerebri). Guides LP, acetazolamide initiation, and bariatric/surgical intervention.

Score interpretation

IIH criteria not met

→ Investigate for secondary cause; rule out venous sinus thrombosis, medication (tetracyclines, isotretinoin, steroids); repeat LP if headache ongoing

Probable IIH

→ Ophthalmology review (Humphrey visual fields, OCT); acetazolamide 250-500mg BD (contraindicated in pregnancy — topiramate alternative); weight loss (target 10% body weight); neurology outpatient follow-up

Definite IIH — vision at risk

→ Urgent ophthalmology; acetazolamide (up to 4g/day); weight management programme; optic nerve sheath fenestration or LP shunt if vision deteriorating; IV methylprednisolone for fulminant IIH; bariatric surgery referral if BMI >=35

Interpretation bands for the IIH Criteria. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.