A Case Report of Systemic Steroid Therapy for False Brain Tumors in Children

Abstract

Study design: Case report. Purpose: to study the efficacy of systemic steroid in pediatric pseudotumor cerebri. Introduction: Pseudotumor cerebri is a condition caused by elevated intracranial pressure presenting most commonly with headache. It is a diagnosis of exculsion. Methods: A 15 year old girl presented in our OPD with headache since 3months, more in the posterior aspect, continuous type with severe intensity, non - radiating. On examination, her best corrected visual acuity in right eye was 6/9 and left eye was 6/6parts. She had normal anterior segment, normal IOP. Fundoscopy showed both optic discs edematous, pink in color with blurry disc margins, tortuous disc vessels, edematous peripapillary area. Rest of the retina was normal. Lumbar puncture showed elevated opening CSF pressure and normal CSF composition. Hence, she was diagnosed with IIH. She was started on oral prednisolone 1mg/kgbw once a day dosage, oral acetazolamide 250mg once a day, topical nepafenac 0.1% one drop thrice a day and timolol 0.5% eye drops twice a day. Discussion: The main goals of treatment are alleviation of symptoms, including headache, and preservation of vision. Steroids were commonly used for treating IIH in the past, but cause significant long - term side effects, such as weight gain, that are undesirable in IIH patients. Furthermore, withdrawal of steroids can cause rebound intracranial hypertension. Thus, steroids should not be used routinely for IIH treatment. Results: By the end of one month, patient was relieved of symptoms, best corrected visual acuity was 6/6 in both eyes with normal IOP, normal optic disc in both eyes. Conclusion: Steroids are an effective way of managing idiopathic intracranial hypertension in pediatric patients.