The following is a summary of “Quality of Life in Patients with Confirmed and Suspected Spinal CSF Leaks,” published in the October 2023 issue of Neurology by Liaw et al.
Spontaneous intracranial hypotension (SIH), a debilitating condition with orthostatic headache and limited upright time, is difficult to diagnose and treat, negatively affecting patients’ quality of life (QoL). Researchers started a retrospective study to evaluate QoL and suicidality in confirmed and suspected SIH patients using standardized instruments.
They conducted a cross-sectional survey of adult patients with confirmed and clinically suspected SIH who had been evaluated in their Headache and Facial Pain Program (2016 to 2022). Participants completed validated questionnaires online using REDCap V 11.2.2 to assess general well-being (SF-36), depression (PHQ-9), general anxiety disorder-7 (GAD-7), spiritual well-being during chronic therapy (FACIT-Sp-12), and headache impact (HIT-6). Then, willing participants were interviewed to administer the Columbia-Suicide Severity Rating Scale (C-SSRS) to assess suicidal behavior and ideation.
The results showed 234 patients, and 95 (59 confirmed and 36 clinically suspected) completed the questionnaires. The average age of the cohort was 51.1 years (SD: 15.5), predominantly female (69.5%), white (91.6%), and married (69.5%). Three-quarters (74.5%) experienced the most severe headache category (HIT-6). SF-36 scores were significantly lower (P<.0001) than the general population and lower than reported values for patients with multiple sclerosis and idiopathic intracranial hypertension. Around 49.1% had moderate or worse depression (>10), and 25.4% had mild or worse anxiety (>10). FACIT-Sp-12 scores were notably lower (P<0.0001) in symptomatic participants than in validation cohorts of AIDS and cancer patients. Of the 67 respondents who finished the C-SSRS, 64.2% wished to be dead, and 22.4% exhibited suicidal behavior. Symptom-free SIH patients (n = 22) scored significantly better than symptomatic patients, similar to the general population.
Theft concluded that SIH was associated with severe symptoms and disability, but outcomes improved with successful treatment.
Source: n.neurology.org/content/early/2023/10/10/WNL.0000000000207763