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Visual failure without headache in idiopathic intracranial hypertension.
Arch Dis Child. 2005 Feb; 90(2):206-10.AD

Abstract

AIM

To determine the differences in outcome in a group of children with idiopathic intracranial hypertension (IIH) who do not present with headaches.

METHODS

Differences in epidemiological and aetiological factors, clinical presentation, and visual outcome were investigated in children with a diagnosis of IIH presenting with and without headaches to the Paediatric Neurology and Paediatric Ophthalmology Services at Guy's & St Thomas' Hospitals NHS Trust between 1997 and 2002.

RESULTS

Compared to the 29 children with headaches, the 12 children in the non-headache group were younger (7.3 v 9.5 years), presented with more neurological signs (33% v 10%), and were more likely to present with severe visual failure (33% v 4%), with a tenfold increased risk of an enlarged blind spot or field defects (50% v 5%). Permanent visual failure affected a third of all children in the non-headache group, but was rare in children presenting with headaches (33% v 3%), with one patient registered blind and two severely visually impaired.

CONCLUSION

The management of IIH is difficult in the absence of headache. Visual surveillance is vital. These children were treated with an aggressive management programme to reduce cerebrospinal fluid pressure by repeated lumbar puncture, medication, and early surgical intervention if required. Non-invasive monitoring techniques might contribute to a better understanding of the natural history of IIH, improved management, and visual outcome.

Authors+Show Affiliations

Department of Paediatric Neurology, Guy's & St Thomas' Hospitals NHS Trust, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15665183

Citation

Lim, M, et al. "Visual Failure Without Headache in Idiopathic Intracranial Hypertension." Archives of Disease in Childhood, vol. 90, no. 2, 2005, pp. 206-10.
Lim M, Kurian M, Penn A, et al. Visual failure without headache in idiopathic intracranial hypertension. Arch Dis Child. 2005;90(2):206-10.
Lim, M., Kurian, M., Penn, A., Calver, D., & Lin, J. P. (2005). Visual failure without headache in idiopathic intracranial hypertension. Archives of Disease in Childhood, 90(2), 206-10.
Lim M, et al. Visual Failure Without Headache in Idiopathic Intracranial Hypertension. Arch Dis Child. 2005;90(2):206-10. PubMed PMID: 15665183.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Visual failure without headache in idiopathic intracranial hypertension. AU - Lim,M, AU - Kurian,M, AU - Penn,A, AU - Calver,D, AU - Lin,J-P, PY - 2005/1/25/pubmed PY - 2005/2/11/medline PY - 2005/1/25/entrez SP - 206 EP - 10 JF - Archives of disease in childhood JO - Arch Dis Child VL - 90 IS - 2 N2 - AIM: To determine the differences in outcome in a group of children with idiopathic intracranial hypertension (IIH) who do not present with headaches. METHODS: Differences in epidemiological and aetiological factors, clinical presentation, and visual outcome were investigated in children with a diagnosis of IIH presenting with and without headaches to the Paediatric Neurology and Paediatric Ophthalmology Services at Guy's & St Thomas' Hospitals NHS Trust between 1997 and 2002. RESULTS: Compared to the 29 children with headaches, the 12 children in the non-headache group were younger (7.3 v 9.5 years), presented with more neurological signs (33% v 10%), and were more likely to present with severe visual failure (33% v 4%), with a tenfold increased risk of an enlarged blind spot or field defects (50% v 5%). Permanent visual failure affected a third of all children in the non-headache group, but was rare in children presenting with headaches (33% v 3%), with one patient registered blind and two severely visually impaired. CONCLUSION: The management of IIH is difficult in the absence of headache. Visual surveillance is vital. These children were treated with an aggressive management programme to reduce cerebrospinal fluid pressure by repeated lumbar puncture, medication, and early surgical intervention if required. Non-invasive monitoring techniques might contribute to a better understanding of the natural history of IIH, improved management, and visual outcome. SN - 1468-2044 UR - https://www.unboundmedicine.com/medline/citation/15665183/Visual_failure_without_headache_in_idiopathic_intracranial_hypertension_ L2 - https://adc.bmj.com/lookup/pmidlookup?view=long&pmid=15665183 DB - PRIME DP - Unbound Medicine ER -