Higgins, Nicholas, Pickard, John, Lever, Andrew · JRSM short reports · 2013 · DOI
This study looked at whether some people with ME/CFS might actually have a condition called idiopathic intracranial hypertension (IIH), which involves increased pressure around the brain and spinal cord. The researchers performed lumbar punctures (spinal taps) on ME/CFS patients with headaches and measured the fluid pressure around their spinal cord. They found that some patients improved after the procedure, suggesting a possible link between the two conditions.
This research suggests that elevated intracranial pressure may contribute to symptoms in a subset of ME/CFS patients and that standard diagnostic criteria for IIH may be too stringent for identifying pressure-related pathology in this population. If confirmed, routine ICP screening could identify a treatable cause of ME/CFS symptoms in some patients.
This study does not prove that IIH causes ME/CFS or that it is common in the ME/CFS population, as the sample was small and pre-selected for headache symptoms. The improvement after lumbar puncture does not definitively establish that elevated pressure is the cause of symptoms, and symptomatic improvement from a procedure can be influenced by placebo effects. The study cannot determine the prevalence of IIH in ME/CFS without a larger, unselected patient cohort.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Higgins, Nicholas, Pickard, John, & Lever, Andrew (2013). Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study.. JRSM short reports. https://doi.org/10.1177/2042533313507920
BibTeX
@article{mecfsatlas-higgins-2013-lumbar-puncture,
author = {Higgins, Nicholas and Pickard, John and Lever, Andrew},
title = {Lumbar puncture, chronic fatigue syndrome and idiopathic intracranial hypertension: a cross-sectional study.},
journal = {JRSM short reports},
year = {2013},
doi = {10.1177/2042533313507920},
note = {PubMed: 24475346},
url = {https://www.mecfsatlas.com/evidence/higgins-2013-lumbar-puncture},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/higgins-2013-lumbar-puncture
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