Idiopathic intracranial hypertension (IIH), sometimes called benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC) is a neurological disorder that is characterized by increased intracranial pressure (ICP), in the absence of a tumor or other intracranial pathology.

Explanation of terms

The terms "benign" and "pseudotumor" have often been used for this disorder to make clear that the increased ICP is not caused by a tumor or malignancy. However, these terms belie the significance and potential morbidity of the disorder - Thus, it is most appropriately referred to as IIH, and not by its other names. Cases of increased ICP with a known cause can be called secondary intracranial hypertension (SIH), but for the purposes of this article the distinction is not entirely vital.

Diagnosis

The diagnosis of IIH is one of exclusion. The principle sign of IIH, papilledema, can occur because of brain tumors (hence the term "pseudotumor cerebri," which literally means "false brain tumor"), or in other conditions involving increased ICP. Thus, a thorough evaluation is essential to the diagnosis of IIH. Radiologic imaging scans are, as a rule, normal in IIH save for the finding of small or slit-like cerebral ventricles, and what may appear to be an 'empty' sella turcica (caused by flattening of the pituitary under pressure). Cerebrospinal fluid (CSF) is a clear fluid which surrounds and circulates through the brain and spinal cord - it is to the fluid pressure of the CSF that the concept of 'intracranial pressure' refers. The chronic pressure increase in IIH is, as the word "idiopathic" indicates, of uncertain etiology; Most researchers believe that the body's ability to absorb CSF is somehow impaired in those individuals with IIH. A less likely possibility (one that is now generally dismissed) is that of CSF overproduction. Many scientists and doctors believe that there is also some degree of brain swelling or engorgement.

Signs and symptoms

IIH most commonly affects women, particularly overweight women between ages 15 and 45. However, the disorder is not limited to women, and can affect people of all ages and races, both male and female, of all shapes and sizes. The 'cardinal sign' of IIH is papilledema (swelling of the optic nerves), although some atypical patients may not have papilledema. Occasionally patients may present with abducens or other cranial nerve palsies. Symptoms can include severe headache, pulsatile tinnitus, visual disturbances (e.g. diplopia), nausea/vomiting, etc. Most serious is the potential for permanent loss of vision or even blindness. Risk factors include female gender, obesity, excess or deficiency of vitamin A, certain medications, and some other disorders. In cases linked to medication or other clear causes, the line between truly idiopathic IH and secondary IH (as mentioned above) can become quite murky.

Read more at Wikipedia.org

• [List your site here Free!]

A proposed embargo: Roberts' response
From Townsend Letter for Doctors and Patients, 7/1/05 by H.J. Roberts

Editor:

I am grateful for the forum that the Townsend Letter for Doctors & Patients has provided me over many years concerning issues in contemporary medical and nutritional practice I consider important. They derived from personal observations in patient care and my corporate-neutral researches.

A partial list of these issues includes serious reactions to products containing aspartame ("aspartame disease"), the widespread problem of hypervitaminosis E, the long-term sequelae of elective vasectomy, fluoridation of water, narcolepsy, the management of painful diabetic neuropathy, the hazards inherent in cholesterolophobia and fear of fat, toxic metal contamination of calcium supplements, and a rational approach to the prevention of Alzheimer's disease. Many appear and have been updated in a recent anthology. (1)

These observations fortuitously generated new clues concerning the nature and evolution of significant disorders. Examples are Graves disease (hyperthyroidism), brain tumors, pseudotumor cerebri (benign intracranial hypertension), chronic refractory fatigue, "early" multiple sclerosis, and transitional Alzheimer's disease.

I selected this journal for the publication of these original and often controversial articles for two reasons. First, it was willing to depart from "the party line," a policy that took courage. Second, its unique readership included not only health care professionals, but also highly perceptive "lay" persons seeking constructive insights within the complex realms of treatment and prevention when their own real-world experiences did not jibe with conventional teachings and practices.

Persons in both categories shared a common concern: the usurpation of medical practice and research by aggressive pharmaceutical, food and "nutraceutical" industries whose deep monetary pockets could fund self-serving "evidence-based" studies.

The validity of my choice has been amply reinforced by numerous letters and calls expressing gratitude for the effort involved. Indeed, many stated that these revelations proved not only helpful, but even life-savingOespecially for aspartame victims. In an era beset by the unfortunate financial exploitation of research, several marveled at the absence of any grants for work I chose to do as an obligatory labor of professional love.

But these contributions generated severe criticism in some quarters. More recently, Beverly A. Hall, PhD stated that my letters concerning aspartame risk "lack both an innovative point of view and scientific rigor." (2) Moreover, she suggested at least a partial embargo on future manuscripts. There was a notable omission: failure to indicate any possible conflicts of interest involving grants or honoraria received from related industries as a stimulus to her communication, which also focused on my "broad sweep at sucralose."

I kept wondering if this critic had actually read my 1000-page text, Aspartame Disease: An Ignored Epidemic, (3) when asserting that the evidence for aspartame disease is "excessively thin, rambling, and anecdotal" ... in the face of over 1400 aspartame reactors in my own database. I suspect that just viewing the e-mails I receive on any one day from astute persons alleging the use of this poisonous substance as the cause of their misery, might call for some soul searching. The same would apply to her reflecting on the full-page ad by Ajinomoto in which the value of aspartame is equated with mother's milk! (4)

Additionally, where is the outrage by other credentialed physicians and nutritionists being expressed to the FDA, various impacted regulatory agencies, and major medical/nutrition/dietetic organizations over the ongoing introduction of multiple sweetening substances that have NOT been adequately tested in humans over sufficient periods, and then reported, by corporate-neutral researchers?

A case in point is neotame. This synthetic modification of the aspartame molecule retains its three troublesome components--including the release of free methyl alcohol after ingestion. I vehemently challenged its approval in correspondence to the FDA when it was considering the relevant Food Additive Petition (5) for the foregoing reasons ... obviously to no avail.

The gist of this commentary is summed in two items. First, the letter from New Zealand preceding Hall's remarks asserts: "I fully endorse Dr. Roberts' (October 2004) frightening scenario of increasingly dangerous chemicals, such as Aspartame, being used in children's drinks and foodstuffs in an effort to combat obesity" (7) Second, this recent citation seems appropriate: "You can always recognize the pioneers by the number of arrows in their back." (8)

References

1. Roberts HJ. Useful Insights for Diagnosis, Treatment, Public Health: An Updated Anthology of Original Research 2002, Palm Beach Institute for Medical Research, Inc.

2. Hall BA. Aspartame risk. Townsend Letter for Doctors & Patients 2005; February/March: 104.

3. Roberts HJ Aspartame Disease: An Ignored Epidemic. 2001, West Palm Beach, Sunshine Sentinel Press (www.sunsentpress.com)

4. Advertisement. Functional Foods & Neutraceuticals 2004, November: 41.

5. Roberts HJ. Letter to Food and Drug Administration re Docket No. 98F-0052 (Food Additive Petition for Neotame), March 3, 1998.

6. Roberts HJ. The CACOF Conspiracy: Lessons of the New Millennium 1998, West Palm Beach, Sunshine Sentinel Press (www.sunsentpress.com)

7. Anderson R. School children at increased aspartame risk. Townsend Letter for Doctors & Patients 2005; February/March: 104.

8. Cited in the NY Times Magazine 2005; Feb. 6:31

H. J. Roberts, MD, FACP, FCCP

Palm Beach Inst. for Medical Research

P. O. Box 17799

West Palm Beach, Florida 33416 USA

hjrobertsmd@aol.com

Return to Pseudotumor cerebri

Home

Contact

Resources

Exchange Links

ebay