Re: pseudotumor cerebri in toddler

Posted By CCF neuro MD *!* on January 01, 1998 at 15:27:00:

In Reply to: pseudotumor cerebri in toddler posted by Nicki on December 31, 1997 at 21:57:32:







: Hi, my daughter was very ill over the summer and first hospitalized with what they
thought was kawasaki dz. Turns out it wasn't. Looked a lot like a toxic reaction of some sort.
(Just mom's opinion but don't know what it could have been from).  Two weeks later, she was hosp'd
for dehydration. Three weeks later with pseudotumor cerebri. Opening pressure
was 60.  Had two taps and was on diamox for several weeks. Still haven't received
a diagnosis and she's been unwell for seven months: feels lousy,constant viruses, infections,
joint pain and transient rash, petechui (sic),sunburn-like rashes,
lethargy, loss of appetite, she weighs the same as she did at 2 1/2. She's now
3 1/2 now.  She was seen at Children's Hosp of Alabama by neurologists and
a hematologist when she had the pseudotumor. CAT scan and MRI were normal (just
occluded right sinus on cat scan).  Bone marrow was normal. Liver functions
have been out of whack but are okay now. All antibody tests are normal. Anyway,docs
at children's couldn't tell me what's wrong. We're seeing a ped rheum in a few weeks. Have
you encountered pseudotumor cerebri in a young child after illness, and if so
what kind? How can a person just get something like that for no reason? What might
be some of the causes of pseudotumor in a young child? What sort of rule-outs can
and/or should be done? My daughter has trisomy-21 but a group of developmental peds
have agreed that her present illness isn't related. Oh, platelet count has always been
low to normal. Thanks for any answers/info you can provide about pseudotumor cerebri
in a young child.
Nicki



=
I have reviewed the literature on pseudotumor in children and there is in
fact quite a lot of informatiopn, although the condition is fairly rare
in this age group
Pseudotumor has been described in the following situations :
Renal failure + /- Dialysis
Behcet's disease, SLE
Vitamin A toxicity
Infections             :Tick borne encephalitis, Lyme disease, Malaria
Cerebral sinus thrombosis ( you mentioned this in your message, but I
      am not clear as to whether you are referring to bony or venous sinuses
Drug side effects from : Tetracyclines, Cyclosporin,
Hormonal therapy       : Thyroxine, Beta HCG
Endocrine diseases     : Pituitary failure, Addissons disease
As you can see there is an extensive list of possible underlying disorders, the
rigour with which one would investigate each one depends on the  clinical
picture.
I hope this list will be of some use in trying to get to the bottom of the problem
and I wish you luck