Multidomain Cognitive Impairment in Children With Pseudotumor Cerebri Syndrome
Muhammad Mahajnah1, Ariel T Suchi, Hazar Zahakah
1Child Neurology and Development Center (MM, ATS, HZ, SSR), Hillel-Yaffe Medical Center, Hadera, Israel ; Child Neurology Unit (JG), Bnai-Zion Medical Center, Haifa, Israel ; Pediatric Department (IS, JG), Bnai-Zion Medical Center, Haifa, Israel ; The Ruth and Bruce Rappaport Faculty of Medicine (MM, IS, JG), Technion, Haifa, Israel ; The Triangle Regional Research and Development Center (RS), Kfar Qara, Israel ; and Beit Berl Academic College (RS), Israel.
Insights
Children with pseudotumor cerebri syndrome (PTCS) experience lasting neurocognitive deficits. These cognitive impairments, affecting memory and attention, persist even after PTCS symptoms resolve and treatment concludes.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Ophthalmology
Background:
- Pseudotumor cerebri syndrome (PTCS) is a condition affecting intracranial pressure.
- While adults often experience long-term neurocognitive deficits despite treatment, pediatric outcomes are less understood.
- Prompt treatment of PTCS is crucial for preventing optic nerve damage.
Purpose of the Study:
- To investigate and evaluate the cognitive outcomes in pediatric patients diagnosed with PTCS.
- To determine if neurocognitive deficits persist in children after PTCS treatment.
Main Methods:
- A prospective study was conducted comparing children with PTCS to a healthy control group.
- Neurocognitive function was assessed using the computerized NeuroTrax battery of tests.
- The PTCS group was evaluated 3 months post-diagnosis, excluding those with prior neurological or psychiatric conditions.
Main Results:
- 82 children (26 PTCS, 56 controls) were evaluated; 60% were female, aged 6.5-16 years.
- Children with PTCS showed significantly lower scores in global cognition, verbal memory, executive function, attention, and processing speed.
- No cognitive differences were observed between children actively undergoing treatment and those who had completed it.
Conclusions:
- Pediatric patients with PTCS experience significant and widespread cognitive decline.
- These neurocognitive deficits persist even after the resolution of PTCS symptoms and cessation of treatment.
Background:
Although prompt and suitable treatment of pseudotumor cerebri syndrome (PTCS) leads to an excellent prognosis and can prevent optic nerve atrophy, adults show long-lasting neurocognitive deficits even with prompt treatment. The purpose of our study was to evaluate cognitive outcomes in pediatric patients with PTCS.
Methods:
We performed a prospective study on children diagnosed with PTCS and a healthy control group. Children with pre-existing neurological conditions or psychiatric drug use were excluded. Both groups underwent a neurocognitive evaluation, using the NeuroTrax computerized battery of tests. The PTCS group were tested 3 months after the initial diagnosis.
Results:
We evaluated 82 children (49 females [60%], 6.5-16 years old, mean age 13.3), including 26 diagnosed with idiopathic PTC and 56 controls. Global cognitive score (P < 0.001), verbal memory (P < 0.001), executive function (P < 0.001), attention (P< 0.003), and information processing speed (P < 0.004) were all significantly lower in the PTCS group. No differences were found between children currently being treated and those whose symptoms had resolved and treatment was stopped.
Conclusions:
Children with PTCS experience comprehensive cognitive decline that persists after the resolution of the symptoms and treatment.
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