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  • Title: No evidence of intracranial hypertension in trekkers with acute mountain sickness when assessed noninvasively with distortion product otoacoustic emissions.
    Author: Olzowy B, Abendroth S, von Gleichenstein G, Mees K, Stelter K.
    Journal: High Alt Med Biol; 2014 Sep; 15(3):364-70. PubMed ID: 25163023.
    Abstract:
    AIMS: The role of intracranial hypertension in acute mountain sickness (AMS) is a matter of debate. Distortion product otoacoustic emissions (DPOAEs) can be used to monitor the intracranial pressure (ICP) noninvasively with a level decrease at the frequencies f2=1 and 1.5 kHz indicating elevated ICP. METHODS: DPOAEs (f2=1, 1.5, 2, 3, and 4 kHz), oxygen saturation (Sao2) and the Lake Louise score (LLS) to assess AMS were measured in trekking tourists on the Mount Everest trek in Nepal at 2610 m and 5170 m. RESULTS: Paired data of both altitudes could be obtained of 187 subjects. All results are given in mean±SD. Sao2 was 94.8±2.7% at 2610 m and 79.0±6.9% at 5170 m. While at 2610 m, none of the study subjects had AMS (LLS 0.04±0.02), at 5170 m 82 (43.9%) had AMS when defined as LLS>2, and 31 (16.6%) when defined as LLS>4 (LLS 2.8±2.2). DPOAE levels decreased at altitude in all frequencies without a difference between trekkers with AMS and without AMS. Low Sao2 correlated with high LLS. Low Sao2 correlated with larger DPOAE level decrease only at f2=1 kHz, while the other frequencies showed no correlation. DPOAE level decrease and LLS showed no correlation. CONCLUSIONS: Our data suggest that subjects with AMS symptoms did not have higher ICP compared to healthy subjects. Consequently, it seems unlikely that intracranial hypertension accounts for the symptoms of AMS.
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