J Pediatr Neurol 2015; 13(01): 046-048
DOI: 10.1055/s-0035-1555154
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Octreotide: A Therapeutic Option for Pediatric Pseudotumor Cerebri Syndrome?

Paolo Morabito1, Salvatore Savasta2, Dominique De Vivo3, Anna Claudia Romeo3, Valeria Dipasquale3
  • 1Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina, Italy
  • 2Department of Pediatrics, University of Pavia, IRCCS San Matteo, Pavia, Italy
  • 3Department of Pediatrics, University of Messina, Messina, Italy
Further Information

Publication History

22 October 2014

03 January 2015

Publication Date:
13 July 2015 (online)

Abstract

Pseudotumor cerebri syndrome (PTCS) is a condition of unclear etiology, characterized by increased intracranial pressure (ICP) with normal cerebrospinal fluid contents and no associated anomalies evident in the brain parenchyma. It may be associated with concomitant risk factors, including obesity, endocrine disorders, chronic medical illness, and medications. Clinical signs and symptoms of PTCS in children are heterogeneous, but they usually include headache, papilledema at the funduscopic examination, and visual disturbances (e.g., diplopia and/or vision loss). Irreversible blindness, due to persistently raised ICP, has been also reported in up to 10% of cases. Treatment goal of PTCS is the relief of symptoms and the preservation of visual function, by reducing ICP. Diuretics (e.g., acetazolamide, furosemide) could be regarded as the first-line treatments in PTCS; however, up to 30% of patients do not have a clinical response, making important the identification of alternative (conservative) treatment's choices to avoid the PTCS-related complications (e.g., permanent visual loss) and the necessity of invasive surgical (cerebrospinal fluid diverting) procedures. In this context, octreotide (i.e., a synthetic somatostatin analog) has been previously proposed in some studies as a potential (etiologically targeted) treatment able to revert to PTCS-related manifestations. We hereby discuss the possible role of octreotide in PTCS and hypothesize the possible mechanism of action of this drug in reducing ICP.