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Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study

OBJECTIVE: Unsuspected idiopathic intracranial hypertension (IIH) is found in a significant minority of patients attending clinics with named headache syndromes, if it is specifically sought out. Chronic fatigue syndrome is frequently associated with headache. Could the same be true of chronic fatig...

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Autores principales: Higgins, Nicholas, Pickard, John, Lever, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899735/
https://www.ncbi.nlm.nih.gov/pubmed/24475346
http://dx.doi.org/10.1177/2042533313507920
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author Higgins, Nicholas
Pickard, John
Lever, Andrew
author_facet Higgins, Nicholas
Pickard, John
Lever, Andrew
author_sort Higgins, Nicholas
collection PubMed
description OBJECTIVE: Unsuspected idiopathic intracranial hypertension (IIH) is found in a significant minority of patients attending clinics with named headache syndromes, if it is specifically sought out. Chronic fatigue syndrome is frequently associated with headache. Could the same be true of chronic fatigue? Moreover, there are striking similarities between the two conditions. Could they be related? Attempting to answer these questions, we describe the results of a change in clinical practice aimed at capturing patients with chronic fatigue who might have IIH. DESIGN: Cross-sectional. SETTING: Hospital outpatient and radiology departments. PARTICIPANTS: Patients attending a specialist clinic with chronic fatigue syndrome and headache who had lumbar puncture to exclude raised intracranial pressure. MAIN OUTCOME MEASURES: Intracranial pressure measured at lumbar puncture and the effect on headache of cerebrospinal fluid drainage. RESULTS: Mean cerebrospinal fluid pressure was 19 cm H(2)O (range 12–41 cm H(2)O). Four patients fulfilled the criteria for IIH. Thirteen others did not have pressures high enough to diagnose IIH but still reported an improvement in headache after drainage of cerebrospinal fluid. Some patients also volunteered an improvement in other symptoms, including fatigue. No patient had any clinical signs of raised intracranial pressure. CONCLUSIONS: An unknown, but possibly substantial, minority of patients with chronic fatigue syndrome may actually have IIH. An unknown, but much larger, proportion of patients with chronic fatigue syndrome do not have IIH by current criteria but respond to lumbar puncture in the same way as patients who do. This suggests that the two conditions may be related.
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spelling pubmed-38997352014-01-28 Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study Higgins, Nicholas Pickard, John Lever, Andrew JRSM Short Rep Research OBJECTIVE: Unsuspected idiopathic intracranial hypertension (IIH) is found in a significant minority of patients attending clinics with named headache syndromes, if it is specifically sought out. Chronic fatigue syndrome is frequently associated with headache. Could the same be true of chronic fatigue? Moreover, there are striking similarities between the two conditions. Could they be related? Attempting to answer these questions, we describe the results of a change in clinical practice aimed at capturing patients with chronic fatigue who might have IIH. DESIGN: Cross-sectional. SETTING: Hospital outpatient and radiology departments. PARTICIPANTS: Patients attending a specialist clinic with chronic fatigue syndrome and headache who had lumbar puncture to exclude raised intracranial pressure. MAIN OUTCOME MEASURES: Intracranial pressure measured at lumbar puncture and the effect on headache of cerebrospinal fluid drainage. RESULTS: Mean cerebrospinal fluid pressure was 19 cm H(2)O (range 12–41 cm H(2)O). Four patients fulfilled the criteria for IIH. Thirteen others did not have pressures high enough to diagnose IIH but still reported an improvement in headache after drainage of cerebrospinal fluid. Some patients also volunteered an improvement in other symptoms, including fatigue. No patient had any clinical signs of raised intracranial pressure. CONCLUSIONS: An unknown, but possibly substantial, minority of patients with chronic fatigue syndrome may actually have IIH. An unknown, but much larger, proportion of patients with chronic fatigue syndrome do not have IIH by current criteria but respond to lumbar puncture in the same way as patients who do. This suggests that the two conditions may be related. SAGE Publications 2013-11-21 /pmc/articles/PMC3899735/ /pubmed/24475346 http://dx.doi.org/10.1177/2042533313507920 Text en © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav http://creativecommons.org/licenses/by-nc/2.0/ This is an open-access article distributed under the terms of the Creative Commons Non-commercial Attribution License (http://creativecommons.org/licenses/by-nc/2.0/), which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Higgins, Nicholas
Pickard, John
Lever, Andrew
Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study
title Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study
title_full Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study
title_fullStr Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study
title_full_unstemmed Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study
title_short Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study
title_sort lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899735/
https://www.ncbi.nlm.nih.gov/pubmed/24475346
http://dx.doi.org/10.1177/2042533313507920
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AT leverandrew lumbarpuncturechronicfatiguesyndromeandidiopathicintracranialhypertensionacrosssectionalstudy