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Pediatric pseudotumor cerebri
Brita S Rook1, Paul H Phillips
1Department of Ophthalmology, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Jones Eye Institute, Little Rock, Arkansas, USA.
Insights
Pediatric pseudotumor cerebri (PTC) diagnosis and treatment differ from adults. Revised criteria and risk factors like obesity are key, with Diamox and weight loss showing effectiveness for mild cases.
Area of Science:
- Neurology
- Ophthalmology
- Pediatrics
Background:
- Pseudotumor cerebri (PTC) in children requires tailored management distinct from adults.
- Literature review highlights evolving understanding of pediatric PTC.
Purpose of the Study:
- To review recent findings on pediatric pseudotumor cerebri (PTC) epidemiology, diagnosis, and treatment.
- To emphasize differences between pediatric and adult PTC cases.
Main Methods:
- Literature review of recent studies on pediatric PTC.
- Analysis of diagnostic criteria, risk factors, imaging, and treatment outcomes.
Main Results:
- Revised diagnostic criteria: elevated cerebrospinal fluid pressure >28 cm H2O in children.
- Obesity is a significant risk factor in post-pubertal children.
- MRI findings suggestive of elevated intracranial pressure are similar to adults.
- Diamox and weight loss are effective for mild visual field loss.
- Severe papilledema and decreased vision predict higher risk of visual loss.
Conclusions:
- Recent findings may alter current pediatric PTC diagnosis and treatment practices.
- Pediatric PTC management should consider specific differences compared to adults.
Purpose Of Review:
Recent findings in the literature regarding the epidemiology, diagnosis, and treatment of pediatric pseudotumor cerebri (PTC) are described. In the past, children with PTC have been treated like adult cases; however, the literature highlights important differences between children and adults with PTC.
Recent Findings:
Revised diagnostic criteria define an opening cerebrospinal fluid pressure greater than 28 cm water as elevated in the pediatric population. Obesity is an important risk factor for primary and secondary PTC in post-pubertal children. Magnetic resonance imaging shows findings suggestive of elevated intracranial pressure in children with PTC, similar to those of adults with PTC. Diamox and weight loss are effective treatments for PTC patients with mild visual field loss. Severe papilledema, decreased vision, and optical coherence tomography measures at presentation identify patients at increased risk for subsequent visual loss.
Summary:
Findings summarized in the recent literature may change practice patterns in the diagnosis and treatment of pediatric PTC. Although there are many similarities between the adult and pediatric populations, the differences should be considered when managing children with PTC.
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