Division of Neurology, Women's College Hospital Centre for Headache, University of Toronto, Toronto, Canada.
Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.
Curr Pain Headache Rep. 2019 Jul 10;23(8):58. doi: 10.1007/s11916-019-0795-8.
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.
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.
假性脑瘤综合征（PTC）可发生于儿童及成人；然而，两人群的风险因素及临床表现差异很大。本综述旨在强调儿童 PTC 的特征，以及该人群中需特别考虑的因素；综述其流行病学和人口统计学特征；讨论临床表现、修订后的诊断标准和评估方法；综述治疗策略；并讨论儿童 PTC 的预后和长期结局。
儿童的临床表现可能存在差异，且不如成人明显。在该人群中，视乳头水肿的诊断也颇具挑战。儿童腰椎穿刺的压力上限不同，其截断值为 25cmH20（或镇静或肥胖儿童为 28cmH2O）。与视力丧失、疼痛和生活质量下降相关的发病率使得准确识别、评估和治疗 PTC 儿童显得尤为紧迫。目前尚无随机对照研究为儿童 PTC 的管理提供循证建议。需要进一步的研究来阐明和统一该人群的管理方法。
