Department of Neurology, Perth Children's Hospital, Perth, Western Australia, Australia.
University of Western Australia, Perth, Western Australia, Australia.
J Paediatr Child Health. 2024 Oct;60(10):499-504. doi: 10.1111/jpc.16622. Epub 2024 Jul 16.
This retrospective study aims to analyse the epidemiology, clinical and neuroimaging features, treatment modalities, and outcomes of paediatric idiopathic intracranial hypertension (IIH) in a tertiary care centre in Australia.
Using the International Classification of Diseases Diagnostic Criteria for IIH, we identified and analysed a cohort of children diagnosed with IIH over a 5-year period (2017-2022). Data on patient demographics, symptomatology, examination findings, investigative results, treatments and outcomes were collected from medical records and electronic health records.
A total of 45 cases were analysed. The pre-pubertal group saw a male predominance and the post-pubertal a female one. Increased body mass index was an associated comorbidity in majority of patients. Headaches (89%) and visual symptoms (56%) were the most common symptoms, with tinnitus also seen in 20% of patients. Papilledema was detected in 91% of the cases examined. The commonest neuroimaging features were optic nerve sheath distention (78%) and empty sella (49%). Acetazolamide was the primary treatment, with most patients responding well. Only a minority required surgical intervention. Long-term resolution of headaches was achieved in 89% of patients.
The incidence of paediatric IIH in the West Australian population appears relatively high. It presents with subtle symptoms, emphasising the need for increased awareness among health-care providers. Younger children may represent a distinct subgroup with unique clinical features. Timely diagnosis and aggressive medical management lead to favourable outcomes. However, weight loss interventions showed limited effectiveness. This study underscores the importance of early recognition and management of paediatric IIH to optimise patient outcomes.
本回顾性研究旨在分析澳大利亚一家三级保健中心的儿科特发性颅内高压（IIH）的流行病学、临床和神经影像学特征、治疗方式及结局。
我们使用国际疾病分类诊断标准 IIH，对 5 年来（2017-2022 年）确诊为 IIH 的儿童病例进行了识别和分析。从病历和电子健康记录中收集了患者人口统计学、症状、检查结果、检查结果、治疗和结局的数据。
共分析了 45 例病例。在青春期前组中，男性占优势，而在青春期后组中，女性占优势。大多数患者存在与肥胖相关的合并症。头痛（89%）和视觉症状（56%）是最常见的症状，20%的患者也有耳鸣。在检查的 91%的病例中发现了视乳头水肿。最常见的神经影像学特征是视神经鞘扩张（78%）和空蝶鞍（49%）。乙酰唑胺是主要治疗药物，大多数患者反应良好。只有少数患者需要手术干预。89%的患者长期缓解头痛。
西澳大利亚人群中儿科 IIH 的发病率似乎相对较高。它表现为轻微的症状，这强调了需要提高卫生保健提供者的认识。年龄较小的儿童可能代表一个具有独特临床特征的独特亚组。及时诊断和积极的药物治疗可带来良好的结局。然而，减肥干预措施效果有限。本研究强调了早期识别和管理儿科 IIH 的重要性，以优化患者结局。
