Atypical idiopathic intracranial hypertension

Normal BMI and older patients

B. B. Bruce, Sachin Kedar, G. P. Van Stavern, J. J. Corbett, N. J. Newman, V. Biousse

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

BACKGROUND: Idiopathic intracranial hypertension (IIH) typically affects young, obese women. We examined 2 groups of atypical patients with IIH: those with a normal body mass index (BMI) and those at least 50 years of age. METHODS: A retrospective cohort study of 407 consecutive adult patients with IIH with known BMI from 3 centers was undertaken. Demographics, associated factors, visual acuity, and visual fields were collected at presentation and follow-up. RESULTS: We identified 18 IIH patients (4%) with normal BMI and 19 (5%) aged 50 years or older at the time of diagnosis who were compared with the remainder of the cohort. Medication-induced IIH was more frequent in patients with IIH with normal BMI (28 vs 7%, p = 0.008). No patient with IIH with a normal BMI had severe visual loss in either eye (0 vs 17%, p = 0.09). Older patients with IIH had a lower BMI, but were still generally obese (33 vs 38, p = 0.04). Older patients were less likely to report headache as initial symptom (37 vs 76%, p < 0.001) and more likely to complain of visual changes (42 vs 21%, p = 0.03). Treatment of any type was less likely in older patients (significant for medications: 74 vs 91%, p = 0.004), and they were more likely to have persistent disc edema at last follow-up (median Frisén grade: 1 vs 0, p = 0.002), but had similar, if not better, visual outcomes compared with younger patients. A case-control study did not identify any new medication or risk factor associations. CONCLUSIONS: Patients with normal body mass index and those 50 years or older make up a small proportion of patients with idiopathic intracranial hypertension (IIH), but appear to have better visual outcomes than more typical patients with IIH.

Original languageEnglish (US)
Pages (from-to)1827-1832
Number of pages6
JournalNeurology
Volume74
Issue number22
DOIs
StatePublished - Jun 1 2010

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Pseudotumor Cerebri
Body Mass Index
Visual Fields
Visual Acuity
Headache
Case-Control Studies
Edema
Cohort Studies

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Bruce, B. B., Kedar, S., Van Stavern, G. P., Corbett, J. J., Newman, N. J., & Biousse, V. (2010). Atypical idiopathic intracranial hypertension: Normal BMI and older patients. Neurology, 74(22), 1827-1832. https://doi.org/10.1212/WNL.0b013e3181e0f838

Atypical idiopathic intracranial hypertension : Normal BMI and older patients. / Bruce, B. B.; Kedar, Sachin; Van Stavern, G. P.; Corbett, J. J.; Newman, N. J.; Biousse, V.

In: Neurology, Vol. 74, No. 22, 01.06.2010, p. 1827-1832.

Research output: Contribution to journalArticle

Bruce, BB, Kedar, S, Van Stavern, GP, Corbett, JJ, Newman, NJ & Biousse, V 2010, 'Atypical idiopathic intracranial hypertension: Normal BMI and older patients', Neurology, vol. 74, no. 22, pp. 1827-1832. https://doi.org/10.1212/WNL.0b013e3181e0f838
Bruce BB, Kedar S, Van Stavern GP, Corbett JJ, Newman NJ, Biousse V. Atypical idiopathic intracranial hypertension: Normal BMI and older patients. Neurology. 2010 Jun 1;74(22):1827-1832. https://doi.org/10.1212/WNL.0b013e3181e0f838
Bruce, B. B. ; Kedar, Sachin ; Van Stavern, G. P. ; Corbett, J. J. ; Newman, N. J. ; Biousse, V. / Atypical idiopathic intracranial hypertension : Normal BMI and older patients. In: Neurology. 2010 ; Vol. 74, No. 22. pp. 1827-1832.
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abstract = "BACKGROUND: Idiopathic intracranial hypertension (IIH) typically affects young, obese women. We examined 2 groups of atypical patients with IIH: those with a normal body mass index (BMI) and those at least 50 years of age. METHODS: A retrospective cohort study of 407 consecutive adult patients with IIH with known BMI from 3 centers was undertaken. Demographics, associated factors, visual acuity, and visual fields were collected at presentation and follow-up. RESULTS: We identified 18 IIH patients (4{\%}) with normal BMI and 19 (5{\%}) aged 50 years or older at the time of diagnosis who were compared with the remainder of the cohort. Medication-induced IIH was more frequent in patients with IIH with normal BMI (28 vs 7{\%}, p = 0.008). No patient with IIH with a normal BMI had severe visual loss in either eye (0 vs 17{\%}, p = 0.09). Older patients with IIH had a lower BMI, but were still generally obese (33 vs 38, p = 0.04). Older patients were less likely to report headache as initial symptom (37 vs 76{\%}, p < 0.001) and more likely to complain of visual changes (42 vs 21{\%}, p = 0.03). Treatment of any type was less likely in older patients (significant for medications: 74 vs 91{\%}, p = 0.004), and they were more likely to have persistent disc edema at last follow-up (median Fris{\'e}n grade: 1 vs 0, p = 0.002), but had similar, if not better, visual outcomes compared with younger patients. A case-control study did not identify any new medication or risk factor associations. CONCLUSIONS: Patients with normal body mass index and those 50 years or older make up a small proportion of patients with idiopathic intracranial hypertension (IIH), but appear to have better visual outcomes than more typical patients with IIH.",
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