Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
J Headache Pain. 2024 Jun 25;25(1):106. doi: 10.1186/s10194-024-01794-3.
Currently, there is a relative lack of detailed reports regarding clinical presentation and outcome of idiopathic intracranial hypertension in Asians. This study aims to describe the clinical features and treatment outcomes of Korean patients with idiopathic intracranial hypertension.
We prospectively recruited patients with idiopathic intracranial hypertension from one hospital and retrospectively analyzed the medical records of 11 hospitals in Korea. We collected data regarding preceding medical conditions or suspected medication exposure, headache phenotypes, other associated symptoms, detailed neuroimaging findings, treatments, and outcomes after 1-2 and 3-6 months of treatment.
Fifty-nine (83.1% women) patients were included. The mean body mass index was 29.11 (standard deviation, 5.87) kg/m; only 27 patients (45.8%) had a body mass index of ≥ 30 kg/m. Fifty-one (86.4%) patients experienced headaches, patterns of which included chronic migraine (15/51 [29.4%]), episodic migraine (8/51 [15.7%]), probable migraine (4/51 [7.8%]), chronic tension-type headache (3/51 [5.9%]), episodic tension-type headache (2/51 [3.9%]), probable tension-type headache (2/51 [3.9%]), and unclassified (17/51 [33.3%]). Medication overuse headache was diagnosed in 4/51 (7.8%) patients. After 3-6 months of treatment, the intracranial pressure normalized in 8/32 (25.0%), improved in 17/32 (53.1%), no changed in 7/32 (21.9%), and worsened in none. Over the same period, headaches remitted or significantly improved by more than 50% in 24/39 patients (61.5%), improved less than 50% in 9/39 (23.1%), and persisted or worsened in 6/39 (15.4%) patients.
Our findings suggest that the features of Asian patients with idiopathic intracranial hypertension may be atypical (i.e., less likely obese, less female predominance). A wide spectrum of headache phenotypes was observed. Medical treatment resulted in overall favorable short-term outcomes; however, the headaches did not improve in a small proportion of patients.
目前，亚洲人群特发性颅内高压的临床表现和结局的详细报告相对较少。本研究旨在描述韩国特发性颅内高压患者的临床特征和治疗结果。
我们前瞻性地从一家医院招募特发性颅内高压患者，并回顾性分析了韩国 11 家医院的病历。我们收集了与先前的医疗条件或疑似药物暴露、头痛表型、其他相关症状、详细的神经影像学发现、治疗以及治疗后 1-2 个月和 3-6 个月的结局相关的数据。
共纳入 59 例（83.1%为女性）患者。平均体重指数为 29.11（标准差为 5.87）kg/m2；仅 27 例（45.8%）的体重指数≥30 kg/m2。51 例（86.4%）患者出现头痛，头痛模式包括慢性偏头痛（15/51 [29.4%]）、发作性偏头痛（8/51 [15.7%]）、可能的偏头痛（4/51 [7.8%]）、慢性紧张型头痛（3/51 [5.9%]）、发作性紧张型头痛（2/51 [3.9%]）、可能的紧张型头痛（2/51 [3.9%]）和未分类（17/51 [33.3%]）。4/51 例（7.8%）患者被诊断为药物过度使用性头痛。治疗 3-6 个月后，8/32 例（25.0%）颅内压正常，17/32 例（53.1%）改善，7/32 例（21.9%）无变化，无一例恶化。同期，39 例患者中 24 例（61.5%）头痛缓解或显著改善超过 50%，9 例（23.1%）改善不足 50%，6 例（15.4%）头痛持续或加重。
我们的研究结果表明，亚洲特发性颅内高压患者的特征可能不典型（即肥胖程度较低，女性比例较低）。观察到广泛的头痛表型。药物治疗在短期内取得了总体良好的结果，但一小部分患者的头痛并未改善。
