Rebecca Barmherzig1,2, Christina L Szperka3,4. 1. Division of Neurology, Women's College Hospital Centre for Headache, University of Toronto, Toronto, Canada. 2. Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada. 3. Pediatric Headache Program, Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. Szperka@email.chop.edu. 4. Department of Neurology, Perelman School of Medicine, University of Pennsylvania, CTRB 10019 3501 Civic Center Blvd., Philadelphia, PA, 19104, USA. Szperka@email.chop.edu.
Abstract
PURPOSE OF REVIEW: Pseudotumor cerebri syndrome (PTCS) may affect both children and adults; however, the risk factors and clinical presentation vary greatly between these populations. This review aims to highlight the entity of PTCS in children and the unique considerations in this population; review the epidemiology and demographics; discuss the clinical presentation, revised diagnostic criteria, and approach to evaluation; review management strategies; and discuss the prognosis and long-term outcomes in children with PTCS. RECENT FINDINGS: Clinical presentation can be variable in children and may be less obvious than in their adult counterparts. Papilledema can also be challenging to diagnose in this population. The upper limits for opening pressure on lumbar puncture differ in children, with a cut-off of 25 cm H20 (or 28 cm H2O in a sedated or obese child). Morbidity related to visual loss, pain and reduced quality of life lends urgency towards accurately identifying, evaluating and managing children with PTCS. There are no randomised controlled studies to allow for evidence-based recommendations for the management of PTCS in children. Further studies are needed to clarify and consolidate management approaches in this population.
PURPOSE OF REVIEW: Pseudotumor cerebri syndrome (PTCS) may affect both children and adults; however, the risk factors and clinical presentation vary greatly between these populations. This review aims to highlight the entity of PTCS in children and the unique considerations in this population; review the epidemiology and demographics; discuss the clinical presentation, revised diagnostic criteria, and approach to evaluation; review management strategies; and discuss the prognosis and long-term outcomes in children with PTCS. RECENT FINDINGS: Clinical presentation can be variable in children and may be less obvious than in their adult counterparts. Papilledema can also be challenging to diagnose in this population. The upper limits for opening pressure on lumbar puncture differ in children, with a cut-off of 25 cm H20 (or 28 cm H2O in a sedated or obesechild). Morbidity related to visual loss, pain and reduced quality of life lends urgency towards accurately identifying, evaluating and managing children with PTCS. There are no randomised controlled studies to allow for evidence-based recommendations for the management of PTCS in children. Further studies are needed to clarify and consolidate management approaches in this population.
Authors: Ali G Hamedani; Kailyn F R Witonsky; Mahgenn Cosico; Robert Rennie; Riu Xiao; Claire A Sheldon; Grace L Paley; Shana E McCormack; Geraldine W Liu; Deborah I Friedman; Grant T Liu; Christina L Szperka Journal: Headache Date: 2018-08-23 Impact factor: 5.887
Authors: M W Ko; S C Chang; M A Ridha; J J Ney; T F Ali; D I Friedman; L J Mejico; N J Volpe; S L Galetta; L J Balcer; G T Liu Journal: Neurology Date: 2011-05-03 Impact factor: 9.910
Authors: Süreyya Burcu Görkem; Selim Doğanay; Mehmet Canpolat; Gonca Koc; Mehmet S Dogan; Hüseyin Per; Abdülhakim Coşkun Journal: Childs Nerv Syst Date: 2014-10-31 Impact factor: 1.475
Authors: Lulu L C D Bursztyn; Sapna Sharan; Leah Walsh; G Robert LaRoche; Johane Robitaille; Inge De Becker Journal: Can J Ophthalmol Date: 2014-02 Impact factor: 1.882
Authors: Francesco Del Monte; Laura Bucchino; Antonia Versace; Irene Tardivo; Emanuele Castagno; Giovanni Pieri; Giulia Pilloni; Enrico Felici; Antonio Francesco Urbino Journal: Ital J Pediatr Date: 2022-01-10 Impact factor: 2.638
Authors: Manolis Polemikos; Elvis J Hermann; Hans E Heissler; Hans Hartmann; Joachim K Krauss Journal: Childs Nerv Syst Date: 2021-02-08 Impact factor: 1.475