Pediatric Pseudotumor Cerebri: Epidemiological Features.

Gabriella D'Alonzo,Francesca Monteu,Raffaele Nuzzi

doi:10.2174/1874364102014010047

Abstract

Objective: The purpose was to study the epidemiological and clinical features of Pediatric Pseudotumor Cerebri; we especially evaluated age, sex, sexual maturity, weight, symptoms, duration of the episode, visual acuity, correlation with systemic diseases or drugs. Methods: We investigated a population of 40 children (80 eyes), aged between 2 and 18 years, that referred to our Centre (Città della Salute e della Scienza di Torino - presidio Ospedale Regina Margherita) from 2000 to 2018. All the patients were monitored with visual field exam, fundus exam and Frisen classification, pupillary reflexes, best corrected visual acuity, orthoptic exam. Then, the demographic characteristics, BMI (body max index) and weight changes, the correlation with systemic diseases or drugs, the Relative Afferent Pupillary Defect (RAPD), the VI cranial nerve deficit, the time required for the diagnosis, the modality of onset, the correlation between diagnosis delay and best corrected visual acuity, the resolution time and the probability of recurrence were studied. Results: We observed 2 age peaks in our population, one consisting of adolescents (aged between 11 and 14 years) and one consisting of younger children aged between 4 and 7 years, with a statistically significant correlation between age and BMI. The deficit of the VI cranial nerve and the diplopia were resolved within the first month, despite the longer time of resolution of the papilledema. Headache was the main onset symptom, but after reclassifying onset symptoms per weight classes, in overweight children, we found an increased variability of symptoms (dizziness, postural instability, photophobia, nausea, vomit, strabism and diplopia, visual fogging, drowsiness, irritability). Moreover, we found only one totally asymptomatic case, during a routine visit, in a 6 years old overweight child with Down syndrome. Conclusion: The Pediatric Pseudotumor Cerebri is, even nowadays, a little known pathology. To provide a correct diagnostic assessment, it will be imperative to recollect the epidemiological features of this disease.

Highlights

To provide a correct diagnostic assessment, it will be imperative to recollect the epidemiological features of this disease
The Pediatric Idiopathic Intracranial Hypertension or Pseudotumor Cerebri is a clinical condition characterized by a raised intracranial pressure and papilledema in the absence of
We enrolled 40 patients (80 eyes) with the diagnosis of Pseudotumor Cerebri, who met Dandy's modified criteria, aged from 2 to 18 years old; 40 patients included 20 girls and 20 boys, who were monitored in our Hospital (Città della Salute e della Scienza di Torino - presidio Ospedale Regina Margherita) from 2000 to 2018

Summary

Introduction

The Pediatric Idiopathic Intracranial Hypertension or Pseudotumor Cerebri is a clinical condition characterized by a raised intracranial pressure and papilledema in the absence of it predominantly affects young adult obese women, it can be diagnosed in children of all ages, and in these populations, it has distinguishing characteristics. It has an incidence of between 12 and 28 per 100,000 adult. The same authors have established a lumbar pressure ≥ 28 cm H2O as diagnostic criteria in children younger than 8 years old [3 - 6].

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Conclusion