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Risk factors for idiopathic intracranial hypertension in men: a case-control study
J Alexander Fraser1, Beau B Bruce, Janet Rucker
1Department of Ophthalmology, Emory University, Atlanta, GA, USA. jfrase2@emory.edu
Journal of the Neurological Sciences
|December 1, 2009
Summary
Men with idiopathic intracranial hypertension (IIH) may experience symptoms of testosterone deficiency and obstructive sleep apnea (OSA). These findings suggest a potential link between sex hormones, OSA, and the development of IIH in males.
Area of Science:
- Neurology
- Endocrinology
- Sleep Medicine
Background:
- Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by increased intracranial pressure without a clear cause.
- While commonly associated with women of childbearing age, risk factors in men are less understood.
- Identifying specific risk factors in men is crucial for diagnosis and management.
Purpose of the Study:
- To investigate potential risk factors for idiopathic intracranial hypertension (IIH) specifically in men.
- To explore the association between IIH and conditions such as testosterone deficiency and obstructive sleep apnea (OSA) in the male population.
Main Methods:
- A case-control study was conducted comparing 24 men diagnosed with IIH to 48 matched controls.
- Participants completed a retrospective telephone questionnaire including validated instruments for Androgen Deficiency in Aging Males (ADAM) and obstructive sleep apnea (OSA) (Berlin questionnaire).
- Statistical analysis utilized Mantel-Haenszel odds ratios and mixed-effects logistic regression, accounting for matching and body mass index (BMI).
Main Results:
- Men with IIH showed a significantly higher likelihood of having a positive ADAM questionnaire, indicating testosterone deficiency (OR: 17.4, p<0.001).
- A significantly greater proportion of men with IIH reported symptoms of OSA or a history of diagnosed OSA (OR: 4.4, p=0.03).
- While BMI categories were matched, a slight difference in actual BMI values was observed between cases and controls (p=0.03).
Conclusions:
- Men diagnosed with IIH exhibit a higher prevalence of symptoms related to testosterone deficiency and obstructive sleep apnea (OSA).
- These findings suggest that sex hormones and OSA may play a significant role in the underlying mechanisms (pathogenesis) of IIH in men.
- Further research is warranted to elucidate the specific pathways and potential therapeutic implications.
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