Pseudotumor cerebri in pediatric patients: a retrospective analysis of diagnostic challenges and possible treatments / Johanna Kósa [et al.]
Bibliogr.: p. 44. - Abstr. eng.
In: Hungarian Pediatrics. - ISSN 3004-0272. - 2024. 2. évf. 4. sz., p. 42-44. : ill.
lntroduction: ldiopathic intracranial hypertension is a rare neurological disorder characterized by symptoms of increased intracranial pressure (headache, nausea, visual disturbances, papilledema), but the underlying cause often remains unclear despite detailed investigations. The incidence is approximately 0,6-0.7 per 100,000 children. purpose and Methods: Cases of suspected idiopathic intracranial hypertension in our Pediatric Department during the last two yeris *rru reviewed, including g children aged between 7 and 16 years. The aim of the study was to analyze the symptoms, the investigations performed, the possible influencing factors and the therapies applied. Results: After additional examinations and ophthalmologic consultations, we found explanations for the symptoms in 4 out of the initial g cases, leading to a final diagnosis of idiopathic intracranial hypertension in 5 cases. All patients presented with headache and visual disturbances and were initially seen by an ophthalmologist, who referred them to our department due to observed papilledema. Upon further investigation, one case was later identified as papilledema caused by drusen papilla' one case was misdiagnosed papilledema, and one case was found to be due to neuroborreliosis. All confirmed cases were initially treated with acetazolamide. Three out of five patients were obese. Conclusion: Based on the results, it should be emphasized that even with a negative cranial MRI result, further investigation is necessary in cases of papilledema. The initial ophthalmologic diagnosis of papilledema should be considered with caution in the absence of appropriate clinical evidence, as detailed investigation may reveal other etiologies. Measuring cerebrospinal fluid pressure is technically simple and does not require special equipment, regardless of obesity. lf pseudotumor cerebri is confirmed, appropriate treatment to reduce intracranial pressure is necessary, as untreated or inadequately treated cases may result in irreversible vision loss. Kulcsszavak: Headache, papilledema, pseudotumor cerebri, idiopathic intracranial hypertension, vision impairment