Kindly spare few minutes and reply my queries mentioned below after going through brief summary of the case. I will be obliged to you very much.
My Wife, aged 33 Years, was diagnosed Idiopathic Intracranial Hypertension (IIH) in Manipal Hospital Bangalore INDIA on 24-Aug-2008 after MRI-Brain, MR Venography, Lumber Puncture and CSF Analysis. Her CSF pressure was measured up to 280 mm H2O. She was prescribed Diamox 1-1-1, Lasix 1-1-0 in beginning and Diamox 1-0-1 after 3 Months. After Nov 2010 doctor has stopped Diamox and started Ciplar LA 40mg 1-0-2 in beginning and Ciplar LA 40mg 1-0-1 after 3 months. She used to get full day headache on reducing dosages of Ciplar. In last 6 months my wife has gained 6-7 Kg weight and we are not sure if this was because of long term use of Beta Blockers (Ciplar LA 40mg).
We have tested her Visual Fields in April & July 2012 which have shown progression in Visual Field Defects in compare to Test done in June 2010. Her MRI Ė Brain and MR Venography was repeated on 21-Jul-2012 which didnít have anything remarkable. Lumber Puncture was repeated on 24-Jul-2012 In Fortis Hospital Bangalore which has measured CSF Pressure up to 24 mm Hg (231 mm H2O). Her Blood tests including Thyroid, Lipids, Liver, Renal, CBC Panel, Glucose Tolerance Ė 75gm, Cortisol, Insulin, HBsAg etc. were in normal range. CSF Protein and Glucose were also in normal range. Her BMI is 40, height 145cm, and Weight 84 Kg. She has been prescribed Diamox 1-1-1, Lasilactone 1-0-1, Reeshape (Orlistat) 1-1-1. Now doctor is emphasizing on Surgery for shunt implant.
1. Can IIH be treated or managed by medicines? If yes, kindly suggest us right treatment?
2. If medicines canít help, which type of surgery is most suitable for her? What is success rate of Surgery for IIH? I read on internet that shunts get blocked very soon. Is it true?
3. Was Beta Blocker a reason for her weight again in spite of controlled diet and exercise?
4. Please suggest a specialist of IIH in Bangalore INDIA.