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Treatment Response in Pediatric Patients With Pseudotumor Cerebri Syndrome

Tovia, Eliel MD; Reif, Shimon MD; Oren, Asaf MD; Mitelpunkt, Alexis MD; Fattal-Valevski, Aviva MD, MHA

doi: 10.1097/WNO.0000000000000516
Original Contribution

Background: Pseudotumor cerebri syndrome (PTCS) is a disorder defined by increased intracranial pressure in the absence of an intracranial space-occupying lesion. This retrospective study aimed to examine the outcomes in children with PTCS.

Methods: Data was collected retrospectively from the charts of consecutive pediatric patients treated for PTCS at our hospital between 2000 and 2007 (60 patients; 36 females, 24 males).

Results: Forty-six patients (76.6%) responded well to acetazolamide therapy, with full resolution of symptoms, including papilledema (average treatment duration 1 year; range: 1 month–5 years). Of the 14 patients with no response to treatment, 9 (23.4%) required surgical intervention. Nonresponders tended to be younger at presentation (8.7 vs 11.5 years, P = 0.04). Twelve patients (26%) experienced relapse after acetazolamide was discontinued. The group that experienced relapse was significantly younger than the nonrelapsers (8.9 vs 12.1 years, P < 0.05).

Conclusions: Younger age at presentation with PTCS was found to be a risk factor for treatment failure or relapse.

Pediatrics Department (ET, SR, AO) and Pediatric Neurology Unit (AM, AFV), Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Address correspondence to Aviva Fattal-Valevski, MD, MHA, Pediatric Neurology Unit, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel; E-mail:

The authors report no conflicts of interest.

© 2017 by North American Neuro-Ophthalmology Society