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The authors note that longer-term longitudinal follow-up is needed to clarify clinical relevance, including visual outcomes and related complications, and highlight that treatment heterogeneity limits immunotherapy–IH interaction analysis. They also argue for larger biomarker or genetic subgroup studies and for accounting metabolic and vascular comorbidities to refine individualized IH risk profiles.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/signs-of-intracranial-hypertension-in-chronic-inflammatory-polyradiculoneuropathies-a-cross-sectional-cohort-study/419901/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/signs-of-intracranial-hypertension-in-chronic-inflammatory-polyradiculoneuropathies-a-cross-sectional-cohort-study/419901.png","ImageObject",300,407,{"name":92,"@type":93},"Guten tag","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main goal of the study discussed in the letter?","Question",{"text":112,"@type":113},"To identify the prevalence and potential associations of intracranial hypertension (IH) signs in patients with inflammatory polyradiculoneuropathy (IPN), previously reported only anecdotally.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why do the authors call for prospective longitudinal research?",{"text":117,"@type":113},"Because a longer-term, prospective follow-up would better determine the clinical relevance of frequent subclinical IH findings, especially for visual outcomes and other related measures.",{"name":119,"@type":110,"acceptedAnswer":120},"How do treatment and comorbidities affect interpretation of IH risk?",{"text":121,"@type":113},"Treatment regimen heterogeneity limits reliable analysis of treatment–IH interactions, and metabolic or vascular comorbidities were not systematically accounted for in the analysis, which future studies should include to build individualized risk profiles.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},419901,1790814572,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},687212321768,"https://ap-avatar.wpscdn.com/avatar/a0010bdbe886d2fe77?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789897067658708522","European Journal of Neurology  \nLETTER TO THE EDITOR  OPEN ACCESS   \nSigns of Intracranial Hypertension in Chronic Inflammatory Polyradiculoneuropathies—A Cross Sectional Cohort Study  \nStefan Macher1,2  | Berthold Pemp3 | Gabriel Bsteh1,2  \n1Department of Neurology, Medical University of Vienna, Vienna, Austria | 2Comprehensive Center for Clinical Neurosciences and Mental Health, Medical  \nUniversity of Vienna, Vienna, Austria | 3Department of Ophthalmology, Medical University of Vienna, Vienna, Austria Correspondence: Stefan Macher ([stefan.macher@meduniwien.ac.at](stefan.macher@meduniwien.ac.at))  \nReceived: 21 November 2025 | Revised: 21 November 2025 | Accepted: 12 December 2025  \nDear Editor,  \nWe thank Dr. Noor un nisa Irshad et al. for their interest in our study “Signs of Intracranial Hypertension in Chronic Inflammatory Polyradiculoneuropathies—A Cross-Sectional Cohort Study” [1] . In response, we wish to convey some key considerations:  \n1 | Long-Term Outcome Data  \nOur study aimed to identify the prevalence and potential associations of intracranial hypertension (IH) signs in patients with inflammatory polyradiculoneuropathy (IPN), which previously was reported only anecdotally. With the benefit of hindsight, a longitudinal follow-up would naturally increase the ability to gauge the clinical relevance of subclinical IH in IPN, particularly regarding visual outcomes, CIDP course, headache, and potentially also cognition. Now, we agree that a prospective longitudinal study over a longer term is needed to determine whether the frequent finding of subclinical IH is relevant in this population.  \n2 | Potential Role of Immunotherapy  \nWe recognize the importance of exploring how immunomodulatory and immunosuppressive therapies might influence IH risk. While most patients in our cohort were receiving treatment at  \nthe time of assessment, the heterogeneity in treatment regimens precluded reliable analysis of treatment-IH interactions. Future prospective studies in larger cohorts might enable us to explore this further, especially in light of case-based evidence suggesting therapeutic modulation of ICP [2–4] .  \n3 | Biomarker or Genetic Subgroup Analyses  \nSubtyping CIDP based on antibody-positivity (e.g., anti-NF155, CNTN1) or other biomarker profiles, while completely hypothetically, could be relevant for stratifying IH risk. Naturally, such subtyping requires much larger sample sizes than available in our study, creating an important avenue for future research to identify mechanistically distinct subgroups potentially more vulnerable to IH.  \n4 | Comorbidities Beyond BMI  \nIndeed, our analysis did not systematically account for metabolic or vascular comorbidities (e.g., diabetes, dyslipidemia, or steroid-induced changes), although patients with known secondary causes of IH (e.g., sinus vein thrombosis, etc.) were excluded. While higher BMI is likely the most relevant cofactor for IH, we concur that metabolic comorbidities may modulate IH risk, and that their inclusion in future analyses would enhance our ability to construct individualized risk profiles.  \n\n| Response to Dr. Noor un nisa Irshad et al. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.\u003Cbr>© 2026 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. |\n\nEuropean Journal of Neurology, 2026; 33:e70491 1 of 2  \n[https://doi.org/10.1111/ene.70491](https://doi.org/10.1111/ene.70491)  \nIn conclusion, we appreciate the authors' insights, which underscore key next steps for research in this emerging area. Our study represents an initial effort to identify and characterize IHin IPN, suggesting a non-negligible prevalence and a possible association with elev","cbCaigrmvNGa9ZIi","https://ap.wps.com/l/cbCaigrmvNGa9ZIi","pdf",129587,"English","# Letter to the Editor\n## Long-Term Outcome Data\n## Potential Role of Immunotherapy\n## Biomarker or Genetic Subgroup Analyses\n## Comorbidities Beyond BMI\n## Conclusion and Disclosures","[{\"question\":\"What was the main goal of the study discussed in the letter?\",\"answer\":\"To identify the prevalence and potential associations of intracranial hypertension (IH) signs in patients with inflammatory polyradiculoneuropathy (IPN), previously reported only anecdotally.\"},{\"question\":\"Why do the authors call for prospective longitudinal research?\",\"answer\":\"Because a longer-term, prospective follow-up would better determine the clinical relevance of frequent subclinical IH findings, especially for visual outcomes and other related measures.\"},{\"question\":\"How do treatment and comorbidities affect interpretation of IH risk?\",\"answer\":\"Treatment regimen heterogeneity limits reliable analysis of treatment–IH interactions, and metabolic or vascular comorbidities were not systematically accounted for in the analysis, which future studies should include to build individualized risk profiles.\"}]","Signs of Intracranial Hypertension in Chronic Inflammatory Polyradiculoneuropathies - A Cross Sectional Cohort Study | PDF",1790618706]