{
  "abstract": "The idiopathic intracranial hypertension (IIH) consensus guidelines were introduced as Trust policy in 2021. This is the first audit into compliance with these guidelines regarding investigation of suspected IIH. A 12-month period of virtual IIH clinics was sampled, and electronic notes for 111 patients were reviewed from initial presentation regarding ophthalmology and neurology assessment, neuroimaging and lumbar puncture.Overall compliance was low; 50% ophthalmology assessments lacked comment or grading of the disc swelling, as well 37% lacking comments regarding visual fields. Compliance with neuroimaging timing was poor, with only 15% receiving neuroimaging within 2 weeks. Rates of with lumbar puncture and neurology referral was better, but over 75% of patients with threatened vision did not receive an urgent lumbar puncture.The lack of compliance is multi-factorial, including changes in staffing, access to timely neuroimaging and awareness of guidelines. IIH is a diagnosis of exclusion and thorough assessment is required to prevent irreversible sight loss and rule out other pathology such as space-occupying lesions. An action plan was devised with neurology and ophthalmology to review the existing guidelines and to disseminate guidance to clinical teams in ophthalmology, neurology, accident and emergency and medical assessment units. Further teaching was also provided regarding investigation of optic disc swelling and IIH.This audit highlights the standard of care for investigating suspected IIH is still low. Improved multi-disciplinary communication to disseminate guidelines and provide training may assist in improving compliance, and re-audit will be required to monitor for improvement to the service being provided",
  "authors": [
    {
      "affiliations": [
        "North West Anglia NHS Foundation Trust, UK",
        "Cambridge University NHS Foundation Trust, UK"
      ],
      "name": "Bethany Ellis"
    },
    {
      "affiliations": [
        "North West Anglia NHS Foundation Trust, UK"
      ],
      "name": "Safdar Alam"
    },
    {
      "affiliations": [
        "North West Anglia NHS Foundation Trust, UK"
      ],
      "name": "Pammal Ashwin"
    }
  ],
  "title": "125937 Audit of compliance with IIH consensus statement for investigation of IIH at first presentation",
  "uid": "7a20e4c0-8a0a-55fd-8a5e-5817f5bf4a4e"
}