RESEARCH ARTICLE


Pediatric Pseudotumor Cerebri: Epidemiological Features.



Francesca Monteu1, 2, *, Gabriella D'Alonzo1, Raffaele Nuzzi2
1 Department of Surgical Sciences, University Ophthalmology Clinic of Turin, Turin, Italy
2 Ophthalmology Clinic, Department of Surgical Sciences, City of Health and Science - Regina Margherita Presidium, Turin, Italy


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Creative Commons License
© 2020 Monteu et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Surgical Sciences, University Ophthalmology Clinic of Turin, Turin, Italy; Tel: +39 348 2507024; Fax: +39 011 2485708; E-mail: francesca.monteu@gmail.com


Abstract

Objective:

The purpose was to study the epidemiological and clinical features of Pediatric Pseudotumor Cerebri; we especially evaluated age, sex, sexual maturity, weight, symptoms, duration of the episode, visual acuity, correlation with systemic diseases or drugs.

Methods:

We investigated a population of 40 children (80 eyes), aged between 2 and 18 years, that referred to our Centre (Città della Salute e della Scienza di Torino - presidio Ospedale Regina Margherita) from 2000 to 2018.

All the patients were monitored with visual field exam, fundus exam and Frisen classification, pupillary reflexes, best corrected visual acuity, orthoptic exam.

Then, the demographic characteristics, BMI (body max index) and weight changes, the correlation with systemic diseases or drugs, the Relative Afferent Pupillary Defect (RAPD), the VI cranial nerve deficit, the time required for the diagnosis, the modality of onset, the correlation between diagnosis delay and best corrected visual acuity, the resolution time and the probability of recurrence were studied.

Results:

We observed 2 age peaks in our population, one consisting of adolescents (aged between 11 and 14 years) and one consisting of younger children aged between 4 and 7 years, with a statistically significant correlation between age and BMI.

The deficit of the VI cranial nerve and the diplopia were resolved within the first month, despite the longer time of resolution of the papilledema.

Headache was the main onset symptom, but after reclassifying onset symptoms per weight classes, in overweight children, we found an increased variability of symptoms (dizziness, postural instability, photophobia, nausea, vomit, strabism and diplopia, visual fogging, drowsiness, irritability). Moreover, we found only one totally asymptomatic case, during a routine visit, in a 6 years old overweight child with Down syndrome.

Conclusion:

The Pediatric Pseudotumor Cerebri is, even nowadays, a little known pathology.

To provide a correct diagnostic assessment, it will be imperative to recollect the epidemiological features of this disease.

Keywords: Pathology, Pediatric pseudotumor cerebri, Diagnostic assessment, Diplopia strabism, Visual fogging, Diplopia.