Pattern of idiopathic intracranial hypertension in Indian population

Abstract

Objective: To evaluate the clinical and demographic profile, laboratory parameters and outcomes of Idiopathic Intracranial hypertension (IIH) patients from Indian subpopulation. Materials and method: We did a prospective study on patients who fulfilled the revised diagnostic criteria for Primary pseudotumor cerebri syndrome in adults and children, proposed by Friedman et al in 2013. All patients were examined for BMI, papilloedema, extraocular muscle movement, opening CSF pressure and underwent MRI, MR venography of brain and perimetry. Patients were followed up for a minimum period of 6 months, upto 2 years, with the outcomes monitored being visual acuity, visual field, headache, diplopia and optic disc changes. Results: We evaluated 33 patients (31 female and 2 male). 25 patients had BMI less than 25. Commonest clinical presentation was headache. 7 patients showed normal CSF opening pressure. The most common MRI finding was flattening of posterior aspect of globe and was found in 90.90% (30). 25 patients showed either unilateral or bilateral transverse sinus stenosis. Most common finding in perimetry was enlarged blind spot. 4 patients recovered spontaneously and rests were treated with acetazolamide (1gm/day). All showed favorable outcome when followed up. Conclusion: Obesity may not be a dominant risk factor for development of IIH in the Indian subcontinent. Non obese IIH have better prognosis and tend to have a good response to medical management alone.

Keywords

• Headache
• idiopathic intracranial hypertension
• obesity
• papilledema
• transverse sinus stenosis