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Pseudotumor Cerebri Syndrome in Children

  • Childhood and Adolescent Headache (S Evers, Section Editor)
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Abstract

Purpose of Review

Pseudotumor cerebri syndrome (PTCS) may affect both children and adults; however, the risk factors and clinical presentation vary greatly between these populations. This review aims to highlight the entity of PTCS in children and the unique considerations in this population; review the epidemiology and demographics; discuss the clinical presentation, revised diagnostic criteria, and approach to evaluation; review management strategies; and discuss the prognosis and long-term outcomes in children with PTCS.

Recent Findings

Clinical presentation can be variable in children and may be less obvious than in their adult counterparts. Papilledema can also be challenging to diagnose in this population. The upper limits for opening pressure on lumbar puncture differ in children, with a cut-off of 25 cm H20 (or 28 cm H2O in a sedated or obese child).

Summary

Morbidity related to visual loss, pain and reduced quality of life lends urgency towards accurately identifying, evaluating and managing children with PTCS. There are no randomised controlled studies to allow for evidence-based recommendations for the management of PTCS in children. Further studies are needed to clarify and consolidate management approaches in this population.

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Funding

Dr. Szperka receives research funding from the National Institute of Health (K23NS102521). There was no specific funding for this project.

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Authors and Affiliations

  1. Division of Neurology, Women’s College Hospital Centre for Headache, University of Toronto, Toronto, Canada

    Rebecca Barmherzig

  2. Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada

    Rebecca Barmherzig

  3. Pediatric Headache Program, Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Christina L. Szperka

  4. Department of Neurology, Perelman School of Medicine, University of Pennsylvania, CTRB 10019 3501 Civic Center Blvd., Philadelphia, PA, 19104, USA

    Christina L. Szperka

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  1. Rebecca Barmherzig
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Correspondence to Christina L. Szperka.

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Dr. Barmherzig declares no conflict of interest. Dr. Szperka has received grant support from Pfizer. Allergan provides consulting payments for work done by Dr. Szperka to the CHOP Paediatric Headache Program.

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Barmherzig, R., Szperka, C.L. Pseudotumor Cerebri Syndrome in Children. Curr Pain Headache Rep 23, 58 (2019). https://doi.org/10.1007/s11916-019-0795-8

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