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Improving pediatric idiopathic intracranial hypertension care: a retrospective cohort study
Adi Nitzan-Luques1,2,3, Yarden Bulkowstein2,4, Noa Barnoy5
1Pediatric Department, Hadassah Medical Center, Ein-Kerem Campus, Jerusalem, Israel.
Insights
Pediatric idiopathic intracranial hypertension (IIH) management is best handled in multidisciplinary clinics. This approach reduces hospital readmissions and improves quality of life for children with IIH.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Clinical Management
Background:
- Idiopathic intracranial hypertension (IIH) in children presents with increased intracranial pressure, headaches, and visual issues.
- IIH is a significant, yet preventable, cause of vision loss in pediatric patients.
- Standardized management protocols for pediatric IIH are not well-established.
Purpose of the Study:
- To describe the clinical course and prognosis of pediatric idiopathic intracranial hypertension (IIH).
- To evaluate the optimal management setting for pediatric IIH patients.
- To identify factors influencing disease control and patient outcomes.
Main Methods:
- Retrospective review of 82 pediatric patients diagnosed with IIH between 2007 and 2018.
- Comparison of outcomes for children managed in multidisciplinary clinics versus individual experts.
- Analysis of demographic, clinical data, and hospital return rates as a marker for disease control.
Main Results:
- Children followed in multidisciplinary clinics had significantly lower and later recurrent IIH-related hospital returns.
- Multidisciplinary follow-up was associated with improved quality of life and reduced financial burden.
- Prompt diagnosis, treatment, and follow-up are crucial for preventing permanent visual impairment.
Conclusions:
- Multidisciplinary clinic follow-up is superior for managing pediatric IIH compared to individual expert care.
- This integrated approach enhances patient outcomes, reduces disease recurrence, and preserves vision.
- Optimizing the management setting is key to improving the long-term prognosis for children with IIH.
Abstract:
To describe the clinical course and prognosis of pediatric idiopathic intracranial hypertension (IIH) and examine the preferred management setting. IIH is characterized by increased intracranial pressure and is often associated with headaches and visual complaints. IIH is a preventable cause of vision loss in children. Hence, a rapid diagnosis followed by prompt treatment and follow-up is essential. However, standardization of the management of IIH in the pediatric population is not well established. Computerized medical charts of all 82 pediatric (< 18 years) patients diagnosed with IIH between 2007 and 2018 in the metropolitan area of Jerusalem were reviewed. Comparison was made between children followed in a multidisciplinary clinic in tertiary centers and those followed elsewhere. Detailed demographic and clinical data, as well as data regarding the follow-up setting and clinical course of the disease, were collected and analyzed. Recurrent IIH-related hospital returns were selected as a measurable marker for the uncontrolled disease. Recurrent IIH-related hospital return rate was significantly lower and occurred later among children followed by multidisciplinary teams compared to individual experts. Follow-up in multidisciplinary clinics improve the quality of life, and financial burden and may prevent permanent visual impairment in children with IIH.
