背景:目前,关于亚洲人特发性颅内高压的临床表现和结局的详细报道相对缺乏。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。
方法:我们前瞻性招募了一家医院的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。我们收集了有关先前医疗状况或可疑药物暴露的数据,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1-2个月和3-6个月后的结局。
结果:纳入59例患者(83.1%为女性)。平均体重指数为29.11(标准偏差,5.87)kg/m2;仅27例患者(45.8%)的体重指数≥30kg/m2。51名(86.4%)患者出现头痛,其中包括慢性偏头痛(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(7.8%)患者被诊断为药物过度使用头痛。经过3-6个月的治疗,颅内压在8/32(25.0%)恢复正常,在17/32(53.1%),7/32年无变化(21.9%),没有恶化。在同一时期,24/39例患者(61.5%)头痛缓解或显著改善超过50%,在9/39(23.1%)中提高了不到50%,6/39(15.4%)患者持续或恶化。
结论:我们的研究结果表明,亚裔特发性颅内高压患者的特征可能不典型(即,不太可能肥胖,女性占主导地位较少)。观察到广泛的头痛表型。药物治疗带来了总体良好的短期结果;然而,一小部分患者的头痛没有改善。
BACKGROUND: 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.
METHODS: 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.
RESULTS: Fifty-nine (83.1% women) patients were included. The mean body mass index was 29.11 (standard deviation, 5.87) kg/m2; only 27 patients (45.8%) had a body mass index of ≥ 30 kg/m2. 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.
CONCLUSIONS: 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.