Visual loss without headache in children with pseudotumor cerebri and growth hormone treatment
| Autor: | Marc-Matthias Steinborn, Bettina Sadowski, Dorothea Besch, Walter Bonfig, Christine Makowski |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Pediatrics genetic structures Pseudotumor cerebri Nausea medicine.medical_treatment Optic Disk Blindness Perceptual Disorders Cerebrospinal fluid medicine Humans Papilledema Child Pseudotumor Cerebri medicine.diagnostic_test business.industry Magnetic resonance imaging Optic Nerve General Medicine medicine.disease Magnetic Resonance Imaging eye diseases Surgery Visual field Growth hormone treatment Growth Hormone Pediatrics Perinatology and Child Health Visual Field Tests Female Neurology (clinical) Hormone therapy medicine.symptom business |
| Zdroj: | Neuropediatrics. 44(4) |
| ISSN: | 1439-1899 |
| Popis: | We report on two prepubescent girls with visual loss due to idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, both treated with recombinant human growth hormone for growth failure. The interval from starting hormone therapy to diagnosis of IIH was 3 and 18 months, respectively. Both girls did not complain of headache and nausea. They were neither obese nor did they suffer from renal insufficiency. In both patients, we observed bilateral optic disc edema with visual loss and elevated cerebrospinal fluid (CSF) pressures. Other causes of IIH were excluded with neuroimaging and CSF examination. Cessation of drug administration is often sufficient for symptom resolution in cases of hormone therapy-associated IIH. However, visual field defects in one girl remained unchanged during follow-up of 8 months. In children with IIH, the spectrum of neurologic and visual manifestations might be variable and unspecific. Diagnosis and management of IIH can be difficult in the absence of headache. Blurred or double vision due to cranial nerve palsy might be the only symptom rather than complaints about reduced visual acuity. Therefore, regular clinical monitoring of visual function and fundus appearance is essential for early diagnosis, efficient management, and improvement of visual outcome in children receiving recombinant human growth hormone. |
| Databáze: | OpenAIRE |
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