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Pseudotumor cerebri syndrome in childhood: incidence, clinical profile and risk factors in a national prospective population-based cohort study

Matthews, Yim-Yee; Dean, Fiona; Lim, Ming J.; Mclachlan, Karen; Rigby, Alan S.; Solanki, Guirish A.; White, Catherine P.; Whitehouse, William P.; Kennedy, Colin R.

Pseudotumor cerebri syndrome in childhood: incidence, clinical profile and risk factors in a national prospective population-based cohort study Thumbnail


Authors

Yim-Yee Matthews

Fiona Dean

Ming J. Lim

Karen Mclachlan

Alan S. Rigby

Guirish A. Solanki

Catherine P. White

William P. Whitehouse

Colin R. Kennedy



Abstract

AIM:
To investigate the epidemiology, clinical profile and risk factors of pseudotumor cerebri syndrome (PTCS) in children aged 1-16?years.

METHODS:
A national prospective population-based cohort study over 25?months. Newly diagnosed PTCS cases notified via British Paediatric Surveillance Unit were ascertained using classical diagnostic criteria and categorised according to 2013 revised diagnostic criteria. We derived national age, sex and weight-specific annual incidence rates and assessed effects of sex and weight categories.

RESULTS:
We identified 185 PTCS cases of which 166 also fulfilled revised diagnostic criteria. The national annual incidence (95% CI) of PTCS in children aged 1-16?years was 0.71 (0.57 to 0.87) per 100?000 population increasing with age and weight to 4.18 and 10.7 per 100?000 in obese boys and girls aged 12-15?years, respectively. Incidence rates under 7?years were similar in both sexes. From 7?years onwards, the incidence in girls was double that in boys, but only in overweight (including obese) children. In children aged 12-15?years, an estimated 82% of the incidence of PTCS was attributable to obesity. Two subgroups of PTCS were apparent: 168 (91%) cases aged from 7?years frequently presented on medication and with headache and were predominantly female and obese. The remaining 17 (9%) cases under 7?years often lacked these risk factors and commonly presented with paralytic squint.

CONCLUSIONS:
This uniquely large population-based study of childhood PTCS will inform the design of future intervention studies. It suggests that weight reduction is central to the prevention of PTCS.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Citation

Matthews, Y., Dean, F., Lim, M. J., Mclachlan, K., Rigby, A. S., Solanki, G. A., …Kennedy, C. R. (in press). Pseudotumor cerebri syndrome in childhood: incidence, clinical profile and risk factors in a national prospective population-based cohort study. Archives of Disease in Childhood, 102(8), https://doi.org/10.1136/archdischild-2016-312238

Journal Article Type Article
Acceptance Date Feb 3, 2017
Online Publication Date Mar 29, 2017
Deposit Date Apr 5, 2018
Publicly Available Date Mar 29, 2024
Journal Archives of Disease in Childhood
Print ISSN 0003-9888
Electronic ISSN 1468-2044
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 102
Issue 8
DOI https://doi.org/10.1136/archdischild-2016-312238
Keywords BPSU; Epidemiology; Obesity; Idiopathic intracranial hypertension; Pseudotumor cerebri
Public URL https://nottingham-repository.worktribe.com/output/852624
Publisher URL http://adc.bmj.com/content/102/8/715

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