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The link between idiopathic intracranial hypertension, fibromyalgia, and CFS: exploration of a shared pathophysiology (2018) Hulens et al.

Discussion in 'ME/CFS research' started by Milo, Dec 24, 2018.

  1. Milo

    Milo Senior Member (Voting Rights)

    The link between idiopathic intracranial hypertension, fibromyalgia, and chronic fatigue syndrome: exploration of a shared pathophysiology

    (This is a hypothesis paper)




    Idiopathic intracranial hypertension (IICH) is a condition characterized by raised intracranial pressure (ICP), and its diagnosis is established when the opening pressure measured during a lumbar puncture is elevated >20 cm H2O in nonobese patients or >25 cm H2O in obese patients.

    Papilledema is caused by forced filling of the optic nerve sheath with cerebrospinal fluid (CSF). Other common but underappreciated symptoms of IICH are neck pain, back pain, and radicular pain in the arms and legs resulting from associated increased spinal pressure and forced filling of the spinal nerves with CSF.

    Widespread pain and also several other characteristics of IICH share notable similarities with characteristics of fibromyalgia (FM) and chronic fatigue syndrome (CFS), two overlapping chronic pain conditions.

    The aim of this review was to compare literature data regarding the characteristics of IICH, FM, and CFS and to link the shared data to an apparent underlying physiopathology, that is, increased ICP.


    Data in the literature regarding these three conditions were compared and linked to the hypothesis of the shared underlying physiopathology of increased cerebrospinal pressure.


    The shared characteristics of IICH, FM, and CFS that can be caused by increased ICP include headaches, fatigue, cognitive impairment, loss of gray matter, involvement of cranial nerves, and overload of the lymphatic olfactory pathway.

    Increased pressure in the spinal canal and in peripheral nerve root sheaths causes widespread pain, weakness in the arms and legs, walking difficulties (ataxia), and bladder, bowel, and sphincter symptoms.

    Additionally, IICH, FM, and CFS are frequently associated with sympathetic overactivity symptoms and obesity. These conditions share a strong female predominance and are frequently associated with Ehlers-Danlos syndrome.


    IICH, FM, and CFS share a large variety of symptoms that might all be explained by the same pathophysiology of increased cerebrospinal pressure
    Inara, DokaGirl, rvallee and 7 others like this.
  2. MeSci

    MeSci Senior Member (Voting Rights)

    Cornwall, UK
    Is that true?

    I put on a lot of weight in the early 2000s - became almost obese - but put it down to anxiety/eating too much, or possibly/likely eating the wrong things. The last conclusion was due to the fact that when I cut out gluten the excess weight just fell away. (I'm also a long-term vegan.)
    sb4 and adambeyoncelowe like this.
  3. Andy

    Andy Committee Member

    Hampshire, UK
    Here are the sections in the paper that mention obesity.
    And here are the references used to support the obesity claims.
    Link, https://adc.bmj.com/content/102/1/35

    Link, https://www.sciencedirect.com/science/article/pii/S2255502117300147?via=ihub
    MeSci likes this.
  4. LadyBirb

    LadyBirb Established Member

    This one may be interesting.
    I have IIH that was diagnosed recently and have had ME/CFS for 3+ years. I’ll start a thread elsewhere though.

    I’ll watch and wait, I’m interested to see where they go because I do feel like some people with the conditions names may need checked for IIH based on varying tidbits I’ve seen described around the web. Hope if the research continues that this hypothesis acknowledges severe ME/cfs and PEM or at least addresses it. Another paper I read on this comparison lacked a lot of understanding of ME (I think it was by different people).
    Trish likes this.

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