Idiopathic Intracranial Hypertension (IIH) Diagnostic Criteria
Applies the Friedman 2013 revised diagnostic criteria for idiopathic intracranial hypertension (pseudotumour cerebri syndrome) in adults and children. Criteria, not a points score.
Score interpretation
The Friedman 2013 criteria for idiopathic intracranial hypertension are not met.
→ Investigate for secondary cause; rule out venous sinus thrombosis, medication (tetracyclines, isotretinoin, steroids); repeat LP if headache ongoing
No papilloedema or VI nerve palsy, but criteria B–E are met with at least 3 of the 4 MRI signs: IIH is suggested but cannot be diagnosed (Friedman 2013).
→ Specialist neurology / neuro-ophthalmology review to confirm the diagnosis; exclude other causes of headache and raised pressure.
Papilloedema with criteria B–D met, but an opening pressure below the diagnostic threshold (Friedman 2013).
→ Ophthalmology review (Humphrey visual fields, OCT); acetazolamide (adults: 250-500mg BD; contraindicated in pregnancy — topiramate alternative); weight loss (target 10% body weight); neurology outpatient follow-up. Children: use a children's formulary.
No papilloedema, but abducens nerve palsy with criteria B–E met (Friedman 2013).
→ Neurology / neuro-ophthalmology review; headache management and weight management; monitor vision (visual fields, OCT).
Papilloedema with criteria B–E met (Friedman 2013).
→ Urgent ophthalmology; acetazolamide (adults: 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. Children: use a children's formulary.
Interpretation bands for the IIH Criteria. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Selexipag · Pulmonary Arterial Hypertension
- Macitentan · Pulmonary Arterial Hypertension
- Acetazolamide (Ménière's Disease) · Carbonic Anhydrase Inhibitor (Diuretic)
- Propranolol (Portal Hypertension) · Antihypertensive
- Carvedilol (Portal Hypertension) · Non-Selective Beta-Blocker with Alpha₁-Blocking Activity
- Acetazolamide · Carbonic anhydrase inhibitor
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.