Idiopathic Intracranial Hypertension in the Northwest of Northern Ireland: Epidemiology and Clinical Management

Abstract

Background: There is limited literature on the epidemiology of idiopathic intracranial hypertension (IIH). The diagnosis and management of IIH require a multidisciplinary approach. We sought to study the incidence as well as prevalence of IIH and to evaluate the current management of IIH in the northwest of Northern Ireland. Methods: Medical records of patients diagnosed with IIH between 2007 and 2014 in a general hospital in Northern Ireland were reviewed. Clinical and outcome data were retrieved. Results: There were 45 patients with IIH, 44 women: 1 man. The mean age at presentation was 29.4 (SD 9.8) years and mean body mass index (BMI) 39.8 (SD 9.5) kg/ m². All patients had neuroimaging, 44 (98%) had CT/MR venogram and 41 (91%) had visual perimetry. The crude incidence of IIH was 2.36 per 100,000 (95% CI 1.65-3.37). For women, the incidence was 4.65 per 100,000/year (95% CI 3.25-6.66). The prevalence was 14.3 per 100,000 overall (95% CI 9.72-20.9) but 28.1 per 100,000 in women (95% CI 19.2-41.2). Visual field defects were identified in 25 of 41 (61%); 4 patients (9%) required shunting procedures. At follow-up, the mean BMI decreased by 1.6 kg/m² (p = 0.024). Conclusions: The incidence of IIH in the northwest of Northern Ireland is among the highest ever reported and probably reflects the known increase in obesity.

Population-based incidence and clinical characteristics of idiopathic intracranial hypertension

“…2,3,5 Additional studies from Japan and Italy have found a much lower incidence, 0.03 in Japan 6 and 0.3 in Italy per 100 000 inhabitants, respectively. 2,3,5 Additional studies from Japan and Italy have found a much lower incidence, 0.03 in Japan 6 and 0.3 in Italy per 100 000 inhabitants, respectively.…”

“…The annual incidence of IIH ranged from 0.9-2.4 per 100 000 individuals in three large-scale studies performed in the USA, Libya and Northern Ireland. 2,3,5 Additional studies from Japan and Italy have found a much lower incidence, 0.03 in Japan 6 and 0.3 in Italy per 100 000 inhabitants, respectively. 7 Several risk factors and co-morbidities have been reported to be associated with IIH and summarized in a meta-analysis by Chen et al 8 However, due to rareness of IIH and few large controlled studies the associations found might be spurious.…”

Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management

“…A recent epidemiology study reported an incidence of IIH occurring in 28/100 000/year,6 which is the highest reported rate in the literature so far 7. In the USA, there was a 320% increase in new cerebrospinal fluid (CSF) shunt procedures for IIH between 1998 and 2002 8.…”

Idiopathic Intracranial Hypertension: Diagnosis and Therapeutic Approach

“…The annual incidence of IIH is approximately 3/100,000 persons and it is usually seen in young obese women (1,2). The major morbidities are headache and vision loss if the disease cannot be diagnosed or the treatment is delayed (3).…”