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Pediatric Pseudotumor Cerebri Syndrome.
Paul H Phillips1, Claire A Sheldon
1Department of Ophthalmology (PHP), Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Jones Eye Institute, Little Rock, Arkansas; and Department of Ophthalmology and Visual Sciences (CAS), University of British Columbia, Vancouver, British Columbia, Canada.
Pediatric idiopathic intracranial hypertension (primary pseudotumor cerebri syndrome) differs from adult cases, with prepubertal children showing no sex predilection. Postpubertal children share risk factors like female gender and obesity with adults.
Area of Science:
- Neurology
- Ophthalmology
- Pediatrics
Background:
- Idiopathic intracranial hypertension (IIH), or primary pseudotumor cerebri syndrome (PTCS), typically affects obese women of childbearing age.
- While less common, children can also be diagnosed with PTCS.
Purpose of the Study:
- To review recent findings on the demographics, diagnosis, and treatment of pediatric PTCS.
- To highlight differences in pediatric PTCS compared to adult cases.
Main Methods:
- Review of recent literature on pediatric PTCS.
- Analysis of demographic data, diagnostic criteria, and treatment modalities.
Main Results:
- Prepubertal children have equal sex distribution and less obesity than adults with PTCS.
- Postpubertal children show female gender and obesity as risk factors.
- Children more frequently exhibit ocular motility deficits and have associated medical conditions.
- Established diagnostic criteria for elevated intracranial pressure (ICP) in children: >25 cm H2O (nonobese, nonsedated) and >28 cm H2O (others).
- MRI findings in children mirror those in adults.
- Optical coherence tomography (OCT) shows potential in distinguishing pseudopapilledema, monitoring treatment in preverbal children, and identifying those at risk for visual loss.
Conclusions:
- Pediatric PTCS presents unique demographic and clinical features compared to adult IIH.
- Further research is needed to define the optimal role of OCT in managing pediatric PTCS.
