Child's Nervous System

, 27:1913

Idiopathic intracranial hypertension in children: visual outcome and risk of recurrence

  • Uri Soiberman
  • Chaim Stolovitch
  • Laura J. Balcer
  • Michael Regenbogen
  • Shlomi Constantini
  • Anat Kesler
Original Paper

Abstract

Purpose

Idiopathic intracranial hypertension (IIH) is a disorder associated with increased intracranial pressure without evidence of a space-occupying lesion and with normal cerebrospinal fluid constituents. The disease is rare in the pediatric population. In this study, we assessed the visual outcome of children with IIH and the risk of recurrence.

Methods

This single-center observational retrospective cohort study included 90 children younger than 18 years of age who satisfied the modified Dandy criteria for the diagnosis of IIH. Upon follow-up, the treatment was discontinued when patients were free of symptoms such as headaches, transient visual obscurations or tinnitus, and when examination revealed no evidence of papilledema. The main outcome measures were visual acuity and visual field outcomes as well as risk of recurrence.

Results

The mean follow-up was 30.65 months (range 1.15–172.6 months, standard deviation 27.47 months). Special grading scales were devised for visual acuity and visual field scores. The mean visual acuity score improved from 4.7 ± 0.62 to 4.87 ± 0.44 (p = 0.003).The mean visual field score improved from 3.41 ± 0.8 to 3.52 ± 0.75 (p = 0.21). The recurrence rate was 23.7%, and the risk of recurrence was highest within the first 18 months after diagnosis of IIH.

Conclusions

These study results suggest that pediatric patients with IIH have a favorable visual outcome in terms of both visual acuity and visual field. If there is any recurrence, it is most likely to occur during the first 18 months after diagnosis.

Keywords

Idiopathic intracranial hypertension Pseudotumor cerebri Pediatrics Recurrence Visual outcome 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Uri Soiberman
    • 1
    • 5
  • Chaim Stolovitch
    • 5
  • Laura J. Balcer
    • 3
  • Michael Regenbogen
    • 5
  • Shlomi Constantini
    • 4
  • Anat Kesler
    • 1
    • 5
  1. 1.Neuro-Opthalmology Unit, Department of OphthalmologyTel Aviv Medical CenterTel AvivIsrael
  2. 2.Pediatric Ophthalmology and Strabismus, Tel Aviv Medical CenterSackler Faculty of Medicine, Tel Aviv UniversityTel AvivIsrael
  3. 3.Department of NeurologyUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  4. 4.Department of Pediatric Neurosurgery, Dana Children’s Hospital, Tel Aviv Medical Center and the Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  5. 5.Department of OphthalmologyTel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv UniversityTel AvivIsrael

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