减肥仍然是特发性颅内高压患者的一个挑战：来自肯尼亚的回顾性病例系列

Q3 Neuroscience

eNeurologicalSci Pub Date : 2025-10-06 DOI:10.1016/j.ensci.2025.100592

Zian Muikamba , Jaskirat Sokhi , Jasmit Shah , Sheila Marco , Juzar Hooker , Dilraj Sokhi

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引用次数: 0

摘要

背景：特发性颅内高压（IIH）是一种以颅内脑脊液压力升高为特征的神经系统疾病，没有明显的病因。导致超重和肥胖的育龄妇女或最近体重变化迅速的育龄妇女特别偏爱的机制仍然没有得到精确的描述。如果不及时诊断，它可能发展为致残的不可逆转的视力丧失。除了药物治疗外，减肥对治疗这种疾病也很有用。撒哈拉以南非洲（SSA）的肥胖人数有所上升，但关于IIH的研究却很少。方法：我们在肯尼亚内罗毕的三级区域转诊神经病学中心进行了回顾性横断面研究。数据摘自2011年1月至2022年12月在AKUHN诊断或治疗的符合IIH诊断标准的18岁患者的医疗档案。结果152例患者：男女比例为9:1，平均年龄34.2岁。平均身体质量指数（BMI）为31.2 kg /m2。几乎三分之一（32.2%）的患者在就诊时至少有一只眼睛视力受损。没有其他医学合并症沉淀IIH。H2O。80.2%的患者有脑部MRI检查，其中78.4%的患者有辅助的IIH影像学检查。中位脑脊液开口压31 cm。治疗方法为乙酰唑胺单独治疗占44%，托吡酯单独治疗占15%，联合治疗占30%。9.8%的患者接受神经外科评估，主要是由于难治性症状或药物治疗不耐受/禁忌症。只有49.3%的患者在一年内症状有所改善。52.6%的人没有正式的书面减肥计划。1年平均BMI为30.9 kg/m2。我们的研究描述了来自东非地区的第一组IIH患者。人口统计数据与国际上报告的一致。然而，我们的患者未能减肥，并强调需要在IIH护理中正式纳入减肥计划（饮食和运动）。

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Weight loss remains a challenge for idiopathic intracranial hypertension patients: A retrospective case series from Kenya

Background

Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by elevated intracranial CSF pressure without demonstratable evident causes. The mechanisms leading to a particular predilection for women of childbearing age who are overweight and obese or who have recent rapid weight changes remain imprecisely described. If undiagnosed, it can progress to disabling irreversible visual loss. Weight loss is useful in addition to medical therapy in treating the condition. There is a rise of obesity in sub-Saharan Africa (SSA) but there is little published on IIH.

Methods

We conducted a retrospective cross-sectional study at our tertiary regional referral neurology centre in Nairobi, Kenya. Data were extracted from medical files of patients meeting the diagnostic criteria for IIH aged >18 years who were diagnosed or managed at AKUHN from January 2011 to December 2022.

Results

We identified 152 patients: female-to-male ratio was 9:1, mean age 34.2 years. Mean body mass index (BMI) was 31.2 kgs/m2. Almost a third (32.2 %) had compromised vision at presentation in at least one eye. None had other medical comorbidities to precipitate IIH. H2O. 80.2 % had brain MRI, of which 78.4 % had ancillary IIH findings on imaging. Median cerebrospinal fluid opening pressure was 31 cm. Treatment was acetazolamide alone in 44 %, topiramate alone in 15 %, and combined in 30 %. 9.8 % were referred for neurosurgical evaluation, mainly due to refractory symptoms or intolerance/contraindications to medical therapy. Only 49.3 % had symptom improvement at one year. 52.6 % did not have a formal documented weight loss plan. Mean BMI at one year was 30.9 kg/m².

Conclusion

Our study describes the first cohort of IIH patients from the East Africa region. Demographics are concordant with those reported internationally. However, our patients failed to lose weight, and emphasizes the need to formally incorporate weight loss plans (diet and exercise) in IIH care.

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来源期刊

eNeurologicalSci Neuroscience-Neurology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

62 days

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