IDIOPATHIC INTRACRANIAL HYPERTENSION IN A PEDIATRIC POPULATION: A TEN YEAR REVIEW OF HISTORICAL, CLINICAL CHARACTERISTICS, LABORATORY PARAMETERS, TREATMENT AND OUTCOME MEASURES

Objectives: To determine important epidemiologic, clinical features, laboratory parameters and prognosis of neurologic and neuro-ophthalmological complications of IIH in children.

Methods: A retrospective review of children <18 years of age treated at the Cleveland Clinic Foundation between January 1995 to October 2005 was performed. Patients were included in the study based on an elevated opening CSF pressure >20cm H20, documented papilledema and neuroimaging results.

Results: During this period 76 patients were treated for IIH, 8 patients were excluded, as they did not have a documented OP, and 3 were excluded as they had an OP less than 20cm H20. Of the remaining 65 patients, 54% were female and 48% were prepubertal (age <13). 19% of the patients with a documented weight were overweight (BMI 25–30), and 27% were obese (BMI>30). Common presenting symptoms included: acute headache (69%), visual changes (61%) and fatigue (29%). All patients had an opening pressure and either a CT or MRI performed. Of the patients with recorded outcome measures, 90% had improved headaches immediately following the LP, 63% at one month, 63% at three months, 25% required surgery, 25% required serial LP's, 76% had improvement in their visual field cuts, and 84% in their visual acuity after treatment.

Conclusion: In any patient who presents with headache and visual symptoms, clinicians should have a high index of suspicion for IIH as early recognition, and aggressive treatment is vital if the serious visual sequelae are to be avoided.