The Clinical Characteristics and Laboratory Findings of Early and Late Onset Pediatric Idiopathic Intracranial Hypertension: A Single-Centre Experience.

Abstract

The objection of the study was to evaluate the features of pediatric idiopathic intracranial hypertension (IIH) at different age groups. This prospective study was done in Pediatric Neurology Department, National Institute of Neurosciences and Hospital, Bangladesh from January 2018 to June 2020. Total 19 cases were enrolled who were clinically suspected and had normal CSF with opening pressure (OP) above 250 mm H2O. They were further categorized as Group I (early- onset pediatric IIH) and Group II (late-onset pediatric IIH) according their age of onset. All patients underwent thorough neurological and ophthalmological evaluations. Clinical and laboratory findings were analyzed by SPSS version 22.0. Mean age was 8.1±2.07 years in Group I and 11.77±0.44 years in Group II. Male were found predominant in Group I while female was more in Group II (p=0.255). Headache (100.0%), vision (70.0%), vomiting (60.0%) irritability (30.0%) and papilledema (90.0%) and sixth nerve palsy (80.0%) were common clinical presentation among Group I. Diffuse headache was more in Group II. Obesity was found significantly more in Group II than Group I (p=0.033). CSF analysis revealed normal cellular and biochemical profiles in all patients. Mean CSF opening pressure was higher in Group I (23.0±9.83 cmH2O) compared with Group II (20.66±4.33 cmH2O), although the difference was not statistically significant. A negative correlation was observed between age and CSF opening pressure. Brain MRI was normal in all cases. Routine laboratory investigations, including complete blood count, liver function tests, serum electrolytes and thyroid function tests, were unremarkable. There was a clear distinction between presentations of early onset and late onset pediatric IIH. Early onset IIH may present with higher CSF opening pressure and less association with obesity, whereas late-onset IIH shows a pattern more similar to adult IIH with increased obesity prevalence.