Is The Cephalalgia Associated With The Use Of Oral Isotretinoin Related To Increased Intracranial Pressure?

Abstract Objective: Although there are studies on the neurological side effects of isotretinoin, the character of headache associated with this medication and its relationship with intracranial hypertension remain poorly elucidated in the literature. The aim of this study is to determine the characteristics of headache in patients developing headache associated with isotretinoin use and whether it is associated with intracranial hypertension. Materials and Methods: A single-center, prospective patient registry study was conducted Between September 2022 and September 2023. Inclusion criteria comprised the absence of any prior primary or secondary diagnosis of headache, the onset of headache within the first 3 months after the initiation of treatment, being 18 years or older, not having any medical conditions that could lead to increased intracranial pressure, and not using any medical treatment that could cause headaches. Exclusion criteria: Being under 18 years of age, being under follow-up for any diagnosed headache, and having papilledema findings during the examination before starting treatment. The dataset encompasses information on the medication dosage, duration of usage, the day the headache occurred, the attributes of the headache, and the findings from the fundus examinationand MRI. Results: A total of 250 patients were evaluated. 65 (%26) patients, who developed headache after medication and met the inclusion criteria, were included in the study. Among the participants who continued to engage in the study, 45 (%61) were female, and 20 (%39) were male, with an average age of 22 (1.8) years. ,The average isotretinoin dosage used by patients with headaches was 34.4 (8.4) mg. Statistically significant higher occurrence of compressive-type headaches was observed when analyzed according to the headache character. In terms of localization, statistically significant differences were noted in the cases of bilateral headaches(P<0.05). However, no significant difference was detected among patients in terms of papilledema and MRI findings (P>0.05). Conclusion: This study demonstrated that headache developing in patients using oral isotretinoin is predominantly of a continuous compressive bilateral nature, yet it is not associated with signs of increased intracranial pressure.