UMEM Educational Pearls

Title: The Rising Incidence of Idiopathic Intracranial Hypertension

Category: Neurology

Keywords: Idiopathic intracranial hypertension, IIH, pseudotumor cerebri, obesity, healthcare utilization (PubMed Search)

Posted: 3/10/2021 by WanTsu Wendy Chang, MD
Click here to contact WanTsu Wendy Chang, MD

Idiopathic intracranial hypertension (IIH) predominantly affects women of childbearing age and is strongly associated with obesity.
Patients can have high rates of healthcare utilization due to their chronic disabling headaches, multiple diagnostic tests and specialist consultations, and potential complications related to treatments.
A recent study looked at trends in the incidence, prevalence, and healthcare outcomes of IIH in the 3.1 million Welsh population over a 14-year period.
- Incidence of IIH increased from 2.3/100,000 to 7.8/100,000 (p<0.001).
- Prevalence of IIH increased from 12/100,000 to 76/100,000 (p<0.001).
- Obesity (BMI >30 kg/m2) also increased from 29% to 40% of the population (p<0.001), with IIH incidence and prevalence strongly associated with BMI.
- Outcomes included blindness (0.78%), moderate visual impairment (1.9%), CSF diversion (9%) with 44% of these patients requiring at least 1 revision surgery.
- IIH patients also had 5.28 times higher rate of unscheduled hospital visits during this time period.

Bottom Line: The incidence and prevalence of IIH is increasing, likely related to rising rate of obesity. This has also been associated with more healthcare utilization compared to the general population.

References

Miah L, Strafford H, Fonferko-Shadrach B, et al. Incidence, prevalence, and health care outcomes in idiopathic intracranial hypertension. Neurology. 2021;96:e1251-1261.

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