Affiliation:
1. Medical University of Vienna, Department of Neurology, Vienna, Austria
2. Medical University of Vienna, Department of Neuroradiology, Vienna, Austria
3. Medical University of Vienna, Department of Ophthalmology, Vienna, Austria
4. Medical University of Vienna, Department of Neurosurgery, Vienna, Austria
Abstract
Abstract
Background: Migrainous headache is common in idiopathic intracranial hypertension (IIH). The aim of this study was to assess its prognostic impact.Methods: We investigated patients with IIH from the Vienna-IIH-database and differentiated migraine (IIH-MIG) from non-migrainous and absent headache (IIH-noMIG). Using multivariate models, we analyzed the impact of IIH-MIG on headache and visual outcomes 12 months after diagnosis. Results: Among 97 patients (88.7% female, mean age 32.9±11.1 years, median BMI 32.0, median CSF opening pressure 31cmH2O), 46.4% were assigned to IIH-MIG and 53.6% to IIH-noMIG (11.3% tension-type, 25.8% unclassifiable, 16.5% no headache). At baseline, IIH-MIG differed from IIH-noMIG with respect to headache frequency (22 vs. 15 days/month, p=0.003) and severity (6.5/10 vs. 4.5/10; p<0.001).At follow-up, the rates for improvement and freedom of headache were lower in IIH-MIG than in IIH-noMIG for all patients (66.7% vs. 88.5%, p=0.009; 11.1% vs. 42.3%, p=0.006) and for those with resolution of papilledema (n=60; 62.1% vs. 93.6%, p=0.003; 17.2% vs. 61.3%, p<0.001). In contrast, visual worsening was significantly less common in IIH-MIG (8.9% vs. 25.0%, p=0.037). Adjusting for covariates, IIH-MIG was independently associated with a significantly lower likelihood of headache improvement (odds ratio [OR] 0.57, p<0.001) and freedom of headache (OR 0.28, p<0.001), but also a lower risk for visual worsening (OR 0.39, p<0.001). Conclusions: In IIH, migrainous headache is associated with unfavorable outcomes for headache, even when papilledema has resolved, and possibly favorable visual outcome.
Publisher
Research Square Platform LLC
Cited by
1 articles.
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