Background: Idiopathic intracranial hypertension (IIH) is a disorder of elevated intracranial pressure without any evidence of intracranial pathology or underlying systemic disease. Obesity was reported as a significant cause of IIH in childhood especially in adolescents.
Objective and hypotheses: IIH is a disorder of elevated intracranial pressure without any evidence of intracranial pathology or underlying systemic disease. Obesity was reported as a significant cause of IIH in childhood especially in adolescents.
Method: 1058 obese children and adolescents were enrolled into the study between January 2011 and January 2013. They were evaluated for IIH by pediatric endocrinologists, neurologists, and ophthalmologist.
Results: Mean age was 10.8±3.1 years, female/male ratio was 1.31. The prevalence of IIH was found as 1.32%. The mean age of cases with IIH was 11.1±2.7 years, female/male ratio was 2.5%. In the cases with IIH; headache rate was 78.6% and frequency of hypertension were significantly higher than in the others (P<0.05). Mild and medium papilledema were found 78.6 and 21.4% respectively. Fasting insulin, HOMA-IR, cortisol levels were found significantly higher than in the obese individuals without IIH (P<0.05). Medical treatment performed in all patients with IIH. Lumboperitoneal shunt was required in only one patient (7.1%). After treatment, 50% of fundoscopic examinations were normal and the others had mild papilledema. None of the patient developed optic atrophy during follow-up period. Recurrence occurred only in one patient (7.1%).
Conclusion: IIH is one of the most serious complication of obesity in childhood. Most of the patients with IIH had intractable headache which impacts life quality and risk of permanent visual loss. Complete resolution of clinical symptoms of IIH is observed by prompt diagnosis and treatment, and serious complications can be prevented. For this reason, obese children and adolescents who have complaint of intractable headache should be evaluated for IIH. Weight losing is one of the most effective ways for regression of IIH alongside other treatments.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology