Idiopathic intracranial hypertension in infancy

Introduction. We present the cases of idiopathic, intracranial hypertension (HII) in children studied in our hospital over the past 15 years (14 cases), reviewing the clinical features, complementary tests, associated causes, treatment and evolution. Patients and methods. Diagnosis of HII was based on a modification of Ahloskog's criteria (1982) (the child was sedated to avoid increased cranial pressure due to crying): no focal signs, CSF pressure greater than 200 mm of H2O, normal composition of CSF and normal neuro-imaging findings. Two groups were established according to age. The first group included those under 24 months old and the second group those over 24 months. Differences were seen in the presenting, symptoms, neurological examination and treatment. Results. In the first group the cause of consultation was irritability and a bulging fontanelle. They recovered after simply restricting fluids and treating the associated cause. In the second group, consultation was for headache and vomiting and sometimes diplopia also. Recovery was satisfactory (except it? one case) when corticosteroids were added to the above treatment. The complementary tests carried out depended on the clinical history, general and neurological examination and associated cause (MR, vitamin A levels, nutritional index, etc). A possible aetiological relationship was found in 75% of cases. Conclusions. We emphasize the favourable course and good prognosis of HII in infants as compared to adults [REV NEUROL 1998; 27: 434-7].