What's New in Childhood Idiopathic Intracranial Hypertension?

Abstract

Idiopathic Intracranial Hypertension (IIH) occurs quite rarely in the paediatric population and its clinical features differ from adults in many ways. Childhood IIH has no sex predilection, and obesity does not appear to be an important factor, especially in prepubertal patients. Newer associations of this disease have been reported that were never reported in the past, mainly due to better understanding of the disease process, changing clinical practice, and technological advancement. Understanding of childhood IIH is very limited as most of the studies regarding the pathogenesis of IIH relate to adults. Prompt diagnosis and treatment is important as children can sustain loss of visual field and acuity despite apparently adequate treatment. Children with IIH should be managed by a multi–disciplinary team consisting of a general paediatrician, a neuro–ophthalmologist, a neurologist, a neurosurgeon, and when appropriate a paediatric neuro–intensivist. The goal of treatment is to relieve symptoms and to preserve vision by normalizing intracranial pressure. Children with IIH should be kept under close surveillance and evaluated for visual acuity, visual fields, colour vision, pupillary function and optic disc oedema.

Keywords:

• Childhood idiopathic intracranial hypertension
• pseudotumour cerebri
• papilloedema
• cerebrospinal fluid pressure
• optic nerve sheath fenestration
• obesity
• lumbo peritoneal shunt