When should a shunt be performed for Ideopathic Intracranial Hypertension?

[bailey102308]

I am a 26 year old female who has sufferred from endometriosis and within the last year had a hysterectomy.  I am a certified Paramedic.  

This past summer I started experiencing headaches, dizziness and nausea.  I felt my vision was deteriorating.  On Dec 1 I went to the opthamologist for a thorough eye exam.  The Dr observed both my optic nerves were swollen and inflamed.  The Dr diagnosed me with Ideopathic Intracranial hypertension.  He immediately sent me for an MRI and ruled out the possibility of tumor or stroke.  I was sent to a neurologist where I was put on Diamox.  I am currently on 1500 in the morning and 1500 at night.  Because of my reaction to the diamox- tingling feet and hands, still headache and still eyes bad I cannot function in my role as a Paramedic.  The neurologist has suggested that I have to stay on the Diamox for another 3 months before he will continue an alternate course of action (shunt).  

So, knowing that I have been on the Diamox for a month and can't get out of bed or function as a Paramedic, does it make sense to wait for 3 more months to do anything else? [Less]

[munchkin689]

heya I have exactly what you have and I had stayed in hospital for a week because I couldnt tolerate the diamox so while in hospital I was supposed to have surgery but instead my consultant decided to keep me on diamox even thou he knew they were making me ill this was is may he sed he would see me in 3 months never heard from him during that time I had to go to lancaster to see my consultant there he told me that my eyes was worse and the swelling at the back of my eye hasnt gone down so now I have had a letter saying that I was having an appointment with a neurosurgeon to have potential surgery from what I have told I would urge youu to see your doctor im only 19 and have a little boii I should of gone sooner than waiting the whole 3 months hope this helps and youu get something sorted hun comment bk please

[Cath278]

Hi Bailey. I have IIh /PTC with paps ( swelling of the optic nerves) and a VP shunt.
I have had this illness for 4 years now.
What you are experiencing on Diamox, the side effects, while terrible! do lesson after about 8 weeks. It does get a bit easier.
Could you talk to your dr about prescribing sequel tablets. They don't seem to cause as many side effects.
Some days, I hate to say, you just have to suck it up and say it saving your eye sight.

It is way to early to even think about shunting.
Shunting, also is not the answer you may hope for.
And once in, it stays there.

I don't think any NS will even consider a shunt so soon in to your diagnoses.At least until the Diomax has a chance to help your eyes.
Try and be patient. I know how terrible Diamox feels,( been on it 3 times so far) but its worth the wait.
Surgery, must always be the last route. All the best Cath

[Dr Sharma]

Dear Bailey, welcome to medhelp forum. In idiopathic intracranial hypertension, the primary concern is to preserve optic nerve function, initially medically and surgically if this is not tolerated. you need to control weight if you are obese. You have been prescribed diuretic acetazolamide to lower the intracranial pressure at a dose of 3g/day which is the higher side and associated with troubling adverse effects like paresthesias, fatigue etc. you can discuss with your neurologist for a change of medication to furosemide, or dose modification of acetazolamide or addition of corticosteroids.  Discuss the annoying side effects that you are having. A close monitor of optic nerve function also needs to be kept, checking for visual acquity, color vision, optic nerve head appearance and perimetry.  Hope this helps.

[selmaS]

  Hi....u do not also have a syrinx or chiari malformation do u?

ICP can be difficult to deal with when meds alone do not help with the excess CSF....a shunt is a last resort....

Many problems can also result from the shunts...so do talk in depth with ur Dr and find a few  Drs and get opinions, but it should only be if this is affecting ur overall health and quality of life.