Pseudotumor cerebri in a pre-pubescent child--case report.

BACKGROUND

Pseudotumor cerebri (PT) is a disease characterized by elevated intracranial pressure with no apparent etiology. A majority of cases of PTC occur in adults, with a distinct predilection for obese women of childbearing age. On rare occasions, PTC will affect children and is associated with different patient characteristics.

METHODS

A slender 10-year-old boy was brought to clinic with a one-day history of intermittent horizontal diplopia and a two-week history of severe headaches on awakening. Visual acuity, pupil function, and color vision were all normal. Cover test revealed an intermittent esotropia at distance, with full ocular motilities. Fundus examination revealed swelling of the optic disks OU. Further diagnostic testing, treatment, and followup are discussed.

CONCLUSIONS

Pseudotumor cerebri in children is rare. When present, PTC in children often manifests different characteristics than adults. First, no clear sexual predilection exists for PTC in children. Second, the role of associated illnesses and medications is stronger in children than in adults. Third, the extent of neurologic deficit present in children with PTC is broader than in adults. All children with swollen optic disks warrant a thorough diagnostic evaluation. In the absence of obvious neuropathology, knowledge of the differences between adult and pediatric PTC can help avoid a diagnostic dilemma.