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Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience

Background: 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. Objectives: To determine the demographics, clinical features, risk factors, and treatment modalit...

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Autores principales: Al-Hashel, Jasem Youssef, Ismail, Ismail Ibrahim, Ibrahim, Mohamed, John, John K., Husain, Fatemah, Kamel, Walaa Ahmed, Behbehani, Raed, Ahmed, Samar Farouk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438786/
https://www.ncbi.nlm.nih.gov/pubmed/32903731
http://dx.doi.org/10.3389/fneur.2020.00672
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author Al-Hashel, Jasem Youssef
Ismail, Ismail Ibrahim
Ibrahim, Mohamed
John, John K.
Husain, Fatemah
Kamel, Walaa Ahmed
Behbehani, Raed
Ahmed, Samar Farouk
author_facet Al-Hashel, Jasem Youssef
Ismail, Ismail Ibrahim
Ibrahim, Mohamed
John, John K.
Husain, Fatemah
Kamel, Walaa Ahmed
Behbehani, Raed
Ahmed, Samar Farouk
author_sort Al-Hashel, Jasem Youssef
collection PubMed
description Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.
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spelling pubmed-74387862020-09-03 Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience Al-Hashel, Jasem Youssef Ismail, Ismail Ibrahim Ibrahim, Mohamed John, John K. Husain, Fatemah Kamel, Walaa Ahmed Behbehani, Raed Ahmed, Samar Farouk Front Neurol Neurology Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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. Frontiers Media S.A. 2020-08-11 /pmc/articles/PMC7438786/ /pubmed/32903731 http://dx.doi.org/10.3389/fneur.2020.00672 Text en Copyright © 2020 Al-Hashel, Ismail, Ibrahim, John, Husain, Kamel, Behbehani and Ahmed. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Al-Hashel, Jasem Youssef
Ismail, Ismail Ibrahim
Ibrahim, Mohamed
John, John K.
Husain, Fatemah
Kamel, Walaa Ahmed
Behbehani, Raed
Ahmed, Samar Farouk
Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience
title Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience
title_full Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience
title_fullStr Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience
title_full_unstemmed Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience
title_short Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience
title_sort demographics, clinical characteristics, and management of idiopathic intracranial hypertension in kuwait: a single-center experience
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438786/
https://www.ncbi.nlm.nih.gov/pubmed/32903731
http://dx.doi.org/10.3389/fneur.2020.00672
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