Article

Idiopathic intracranial hypertension (IIH) is prone to misdiagnosis. Our aim
was to identify the reasons for this in children in our region referred for
suspected IIH. METHOD: We reviewed the records of all children referred with
symptoms and/or signs consistent with raised intracranial pressure (ICP) and
normal magnetic resonance imaging of the brain to our tertiary neurology unit
over 4 years. IIH was confirmed after expert ophthalmology including
ultrasound/tomography and advanced cerebrospinal fluid (CSF) pressure studies.
RESULTS: Of 15 children (six males, nine females; median age 12y, range 3-15y),
six (five females, one male) were confirmed to have IIH. All weighed above the
91st centile and were over 10 years old. Four of the six had raised ICP secondary
to other causes. Four had been misdiagnosed locally with papilloedema, three had
drusen, and one had 'crowded discs'. Two had raised CSF pressures on standard
lumbar puncture, but 20-minute steady state and infusion studies were normal,
with symptoms settling after therapy was withdrawn. INTERPRETATION: Misdiagnosis
of IIH was frequent, but could be reduced by (1) expert ophthalmological
fundoscopy, orbital ultrasound, and optical coherence tomography; (2) expert
neuroradiology; and (3) assessment of steady state CSF pressure rather than
standard opening pressure in centimetres of water.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS