Idiopathic intracranial hypertenion in prepubertal pediatric patient: characteritic, treatment, and outcome Original Reearch Article

PURPOE: To report the feature of idiopathic intracranial hypertenion in prepubertal children, with emphai on preentation, treatment, and outcome. METHOD: We retropectively reviewed the chart of all patient 11 year and younger diagnoed with idiopathic intracranial hypertenion at two univerity-affiliated medical center. Incluion critera included papilledema, normal brain computed tomography or magnetic reonance imaging, cerebropinal fluid preure greater than 200 mm H2O, normal cerebropinal fluid content, and a nonfocal neurologic examination except for ixth nerve paly. Patient with concomitant ytemic illne were excluded. REULT: Of the 10 patient, four were girl and ix were boy. Only one patient wa obee. The mot common preenting ymptom were tiff neck (four patient) and diplopia (four patient), and the mot common preenting ign wa trabimu (eight patient). ix of eight patient with trabimu had abducen nerve paly (four bilateral), one patient had a enory exotropia, and one had a comitant eotropia. Viual field abnormalitie were preent in 11 of 13 eye (85%), and evere viual lo reulting in no light perception viion occurred in one eye of one patient. Nine patient were treated medically, four with a combination of prednione or dexamethaone and acetazolamide and five with acetazolamide alone. One patient in thi group alo required a lumboperitoneal hunt. One patient wa treated with lumbar puncture only. Reolution of papilledema occurred rapidly in all patient, with a mean of 4.7 ± 2.6 month. Reolution of ixth nerve paly alo occurred rapidly in four of ix patient in a mean of 1.6 ± 1.2 month. One patient required trabimu urgery for peritent eotropia and one wa lot to follow-up. CONCLUION: Idiopathic intracranial hypertenion in prepubertal children i rare and i different than the dieae in adult. In our erie, there appeared to be no ex predilection, and obeity wa uncommon. Children are likely to preent with trabimu and tiff neck rather than headache or pulatile tinnitu. Both papilledema and ixth nerve paly reolved rapidly with treatment. However, children can utain lo of viual field and viual acuity depite treatment.