Al-Hashel Jasem Youssef, Ismail Ismail Ibrahim, Ibrahim Mohamed, John John K, Husain Fatemah, Kamel Walaa Ahmed, Behbehani Raed, Ahmed Samar Farouk
Department of Neurology, Ibn Sina Hospital, Kuwait City, Kuwait.
Department of Medicine, Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait City, Kuwait.
Front Neurol. 2020 Aug 11;11:672. doi: 10.3389/fneur.2020.00672. eCollection 2020.
Idiopathic intracranial hypertension (IIH) affects predominantly obese females during their reproductive age period. The demographics of this condition has not been studied in Kuwait before. To determine the demographics, clinical features, risk factors, and treatment modalities of IIH in the main neurology tertiary referral hospital in Kuwait and to compare our data with literature. A retrospective study was conducted to identify cases of IIH seen between January 1, 2018, and December 31, 2018. Patients were diagnosed in and referred from the neurology and neuro-ophthalmology clinics. Our cohort consisted of 139 patients. We estimated a crude annual incidence rate of IIH of 3.28 per 100,000 population. Female-to-male ratio was 9.6:1. Mean age was 32.1 ± 10.8 years. Mean age of males was 31.46 ± 12.63 and that of females was 32.11 ± 10.67. The median of the duration from the first symptoms till diagnosis was 6 weeks (2-10 weeks). Headache was the most common symptom in 134 (96.4%) patients, followed by visual disturbances in 85 (61.2%) patients, transient visual obscurations (TVOs) in 84 (60.4%) patients, pulsatile tinnitus in 72 (51.8%) patients, diplopia in 22 (15.8%) patients, other symptoms (e.g., nausea, vomiting, radicular neck, and back pain) in 19 (13.7%) patients, and 1 (0.7%) patient had facial weakness. High body mass index (BMI) was seen in 89.9% of patients, either overweight or obese, and it was the most common risk factors in both males (46.2%) and females (61.1%). Anemia was found in 38.1%; 21.6% of patients used OCPs and 7.9% used vitamin A. Bilateral transverse sinus stenosis (BTSS) was detected in 47 (33.8%) patients. Only 2 (1.4%) patients developed "fulminant IIH" characterized by rapidly progressive disease. All the patients received medical treatment and only 12 (8.6%) needed surgical management. Incidence of IIH in Kuwait is similar to other regional studies but higher than Western studies. Demographics and clinical features of IIH in our study are comparable to international and regional figures. Most of our patients had a benign course. IIH is more prevalent in females and strongly associated with obesity.
特发性颅内高压（IIH）主要影响处于生育年龄的肥胖女性。此前科威特尚未对该疾病的人口统计学特征进行研究。为了确定科威特主要的三级神经科转诊医院中IIH的人口统计学特征、临床特征、危险因素和治疗方式，并将我们的数据与文献进行比较。我们进行了一项回顾性研究，以确定2018年1月1日至2018年12月31日期间确诊的IIH病例。患者在神经科和神经眼科诊所被诊断并转诊。我们的队列由139名患者组成。我们估计IIH的粗年发病率为每10万人3.28例。女性与男性的比例为9.6:1。平均年龄为32.1±10.8岁。男性的平均年龄为31.46±12.63岁，女性为32.11±10.67岁。从首次出现症状到确诊的中位时间为6周（2 - 10周）。头痛是134例（96.4%）患者中最常见的症状，其次是85例（61.2%）患者出现视力障碍，84例（60.4%）患者出现短暂性视力模糊（TVO），72例（51.8%）患者出现搏动性耳鸣，22例（15.8%）患者出现复视，19例（13.7%）患者出现其他症状（如恶心、呕吐、颈部和背部神经根性疼痛），1例（0.7%）患者出现面部无力。89.9%的患者体重指数（BMI）较高，超重或肥胖，这是男性（46.2%）和女性（61.1%）中最常见的危险因素。38.1%的患者存在贫血；21.6%的患者使用口服避孕药，7.9%的患者使用维生素A。47例（33.8%）患者检测到双侧横窦狭窄（BTSS）。只有2例（1.4%）患者发展为“暴发性IIH”，其特征为疾病迅速进展。所有患者均接受了药物治疗，只有12例（8.6%）需要手术治疗。科威特IIH的发病率与其他地区研究相似，但高于西方研究。我们研究中IIH的人口统计学特征和临床特征与国际和地区数据相当。我们的大多数患者病程良性。IIH在女性中更为普遍，且与肥胖密切相关。
Zotero 插件