Frequency of Idiopathic Intracranial Hypertension in Korea: a prospective multicenter study

초록

Objective: The aim of this prospective study was to examine the frequency of idiopathic intracranial hypertension (IIH) in headache clinics and assess the presence of red flag signs in patients with IIH. Methods: We prospectively collected new consecutive patients with IIH among first-visit patients who visited headache clinics of 11 hospitals in Korea between January 2022 and March 2024. Clinical characteristics, lumbar puncture opening pressures, and neuroimaging findings are collected. We used the SNNOOP10 list to identify the presence of red flags of the patients with IIH. Results: Among 13,028 new headache patients visited to 11 headache clinics, 22 patients were finally diagnosed with IIH (frequency: 0.17% [95% CI 0.11%, 0.25%], 0.19% [95% CI 0.12%, 0.30%] for women and 0.11% [95% CI 0.04%, 0.28%] for men). The median age of the patients was 33 (interquartile range 27–44) years, and 18 (81.8%) were women. Sixteen (72.7%) patients were obese (≥25 kg/m2) according to the criteria of the Asian-Pacific classification; only 11 (50%) had BMI ≥30 kg/m2. All patients with IIH reported one or more red flags of SNNOOP10 list. Papilledema was the most common red flag (n = 14, 63.6%). When we excluded papilledema and flags irrelevant to IIH, 10 (45.5%) had no red flags. Among the headache-related red flags, pattern change or new-onset headache (n = 6, 27.3%) was the most common. Positional headache (n = 2, 9.1%) and precipitation by sneezing, coughing, or exercise (n = 1, 4.5%) were uncommon. Conclusion: The frequency of IIH in headache clinics in Korea was low. Typical obesity profile, clinical characteristics, and papilledema were less common in Korean patients with IIH. Although the SNNOOP10 list seems to be feasible, clinical suspicion alone may be insufficient for the effective screening of IIH, particularly in Koreans.