UAE doctor reports rise in 'false brain tumour' cases linked to obesity

Pseudotumor cerebri causes debilitating headaches and can lead to blindness

Pseudotumor cerebri, also known as a “false brain tumour”, causes severe headaches that can lead to serious and permanent complications if left untreated.

Dr Sumayya Juma Al Marzouqi, consultant ophthalmologist at Sheikh Shakhbout Medical City, says pseudotumor cerebri is more common in young adults, particularly obese women aged between 20 and 40. SSMC

Third-year high school student Saeed Alrashdi said his symptoms started with a high-grade fever and an odd whooshing sound in his ears. Victor Besa / The National. 

People with pseudotumor cerebri should go for regular eye exams and check-ups so that eye problems are diagnosed and treated before they progress. Alamy

Dr Sumayya Al Marzouqi said the numbers of pseudotumor cerebri cases are increasing because of high obesity rates. AFP

A rise in obesity rates was identified as a key factor behind an increase in the number of people with a rare disorder that starts as a debilitating headache but can lead to blindness.

Pseudotumor cerebri, sometimes called idiopathic intracranial hypertension, is a disorder related to high pressure in the brain.

The Latin name means "false brain tumour" because of the similarity in symptoms.

It causes severe headaches that can lead to serious complications if left untreated, including a progressive and permanent loss of vision.

In a study published in January this year, researchers in Wales analysed data from 2003 to 2017 and found that pseudotumor cerebri cases increased six-fold over the course of their study.

The report said the rising numbers corresponded with a similar increase in obesity. Researchers also found that the condition was more prevalent among women.

“One of the most important ways to treat this condition is weight loss,” said Dr Sumayya Al Marzouqi, consultant ophthalmologist at Sheikh Shakhbout Medical City in Abu Dhabi.

“It is not an actual tumour but has the same presentation, which is headache, nausea, vomiting and blurred vision.

“Pseudotumor cerebri is more common in young adults, particularly obese women from the age of 20 to 40. It does occur in children but, with prepubescent children, obesity is not a factor.

“However, once they hit puberty then it becomes a factor and is generally more common in females."

While there is no data in the UAE to show the number of pseudotumor cerebri cases, Dr Al Marzouqi said she noticed a significant increase in recent years.

"I see five to six new cases per week. The numbers are high because obesity rates are high," she said.

"The numbers keep increasing. I started with two cases per week six years ago."

Patients normally go to an ophthalmologist, who later refers them to a neurologist.

Dr Al Marzouqi emphasised the importance of patients losing weight and seeking medical help immediately.

"Again, obesity is a major factor. Losing weight and maintaining a healthy lifestyle is critical," she said.

Genetics are not a factor, she said, and the reason why young adults develop pseudotumor cerebri remains unknown.

There is a theory that when a person is obese, their abdomen puts pressure on the veins, which increases the overall pressure until it reaches the brain, she said.

“The brain is important for CSF [cerebrospinal fluid] production and in these cases it produces more CSF, which increases the pressure,” Dr Al Marzouqi said.

In 2017, the UAE National Diabetes and Lifestyle Study of more than 3,000 non-citizens found that 43 per cent were overweight.

A year later, a UAE national health survey showed the adult prevalence of obesity to be at 27.8 per cent. The rate was 17.35 per cent in children aged between 5 and 17.

While the number of people with this disease is increasing, so too is awareness.

“Previously there was little awareness, but gradually more and more know about it,” Dr Al Marzouqi said.

Emirati Um Ali, 46, started losing her eyesight in January. She could not see clearly, had double vision, a constant headache, dizziness and ringing in her ears.

The mother of four was admitted to SSMC. At the time, she weighed 85 kilograms.

"I had never heard of this disease before. It was a nightmare. I couldn't take care of my children or move at one point," she said.

Her symptoms started to subside only after she lost weight and took medication.

"I've lost more than five kilograms and have already improved. I am gradually losing more," she said.

Secondary school pupil Saeed Al Rashdi is of average weight. His symptoms started with a high-grade fever and an odd whooshing sound in his ears.

The 17-year-old also experienced blackouts whenever he bent over.

In 2018, he went to a private hospital to discuss the problem with an ear, nose and throat specialist and an ophthalmologist. His symptoms only recently improved after visiting SSMC.

“I got better after taking the prescribed medication. The difference I felt is like day and night,” he said.