ESPE Abstracts

Introduction: Obesity is a recognised risk factor for raised intracranial pressure in the adult population but is still under-recognised in children and young people. The pathophysiology of raised intracranial pressure in relation to obesity remains unclear. The aim of our study is to investigate the association between idiopathic intracranial hypertension (IIH) and obesity in children and young people.

Method: Patients diagnosed with IIH by the neurology team at a tertiary children’s hospital were identified over a two-year period. Data including the patients’ growth parameters, presentation, investigation and treatment was collected and analysed.

Results: Eighteen patients (M: F 7: 11) were identified with a mean age at diagnosis of 11 years (± 3.3SD; range: 6 to 15 years). The mean BMI was 30.3kg/m²(range: 13.9 to 58.2kg/m²) and the mean BMI SDS was +2.5 (range: -1.24 to +4.46). 72.2% of the patients had a BMI SDS greater than 2. 12 (66.6%) patients presented with both headaches and eye signs (visual disturbances or ophthalmology findings). 3 patients were asymptomatic, with papilloedema identified on routine optician review. All patients required a lumbar puncture. Only 7 patients were able to have a successful lumbar puncture on the ward with no or little sedation. The others had the procedure performed in theatre or the radiology department. 9 patients required general anaesthetic. 15 patients were treated medically (acetazolamide and/or topiramate), 2 had long-term neurosurgical interventions (ventriculoperitoneal and ventriculoatrial shunts) and 1 patient did not require either.

Conclusion: The results of this study show that females are more likely to develop IIH compared to males and that there is a clear link between IIH and obesity. Hence, awareness about the potential diagnosis of IIH in patients with obesity needs to be raised to ensure early identification and management to avoid permanent visual loss.