A national Swedish case-control study investigating incidence and factors associated with idiopathic intracranial hypertension

Author:

Sundholm Anna1,Burkill Sarah2,Waldenlind Elisabet1,Bahmanyar Shahram3,Nilsson Remahl A Ingela M1

Affiliation:

1. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and Department of Neurology, Karolinska University Hospital, Karolinska University Hospital, Stockholm, Sweden

2. Saw Swee Hock School of Public Health, National University of Singapore, National University of Singapore, Singapore

3. Centre for Pharmacoepidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden and Centre for Phychiatry Research, Karolinska Institutet, Stockholm, Sweden

Abstract

Objective To study the incidence of idiopathic intracranial hypertension in Sweden and to explore whether previously proposed risk factors are associated with idiopathic intracranial hypertension by investigating the odds of exposure one year prior to diagnosis in patients compared to controls. Methods Using Swedish health care registers and validated diagnostic algorithms, idiopathic intracranial hypertension patients diagnosed between 2000–2016 were compared with randomly selected matched controls, five from the general population and five with obesity. Results We identified 902 idiopathic intracranial hypertension patients and 4510 matched individuals in each control group. Mean incidence among inhabitants ≥18 years of age was 0.71 per 100,000; rising from 0.53 in 2000–2005 to 0.95 in 2012–2016. There were increased odds for idiopathic intracranial hypertension patients compared to general population for exposure to: kidney failure (odds ratio =13.2 (4.1–42.0)), arterial hypertension (odds ratio =17.5 (10.5–29.3)), systemic lupus erythematosus (odds ratio =13.8 (4.3–44.7)), tetracyclines, sulphonamides, lithium, and corticosteroids. In obese controls, odds ratios were also significantly increased for these exposures. Hormonal contraceptive use and exposure to pregnancy did not appear to be associated factors for idiopathic intracranial hypertension development. Conclusions The incidence of idiopathic intracranial hypertension in Sweden is lower relative to reports from other countries but is on the rise. This case-control study confirms several previously reported risk factors associated with idiopathic intracranial hypertension.

Funder

The Swedish Headache Society

Stiftelsen Tornspiran

Karolinska University Hospital/Karolinska institutet

Publisher

SAGE Publications

Subject

Clinical Neurology,General Medicine

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