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Under Pressure
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images], one patient had swelling of their left ring finger [photo & x-ray], one patient had swelling of the right buttock and thigh [photo & MRI], two patients had glossal hamartoma [photos], one patient had a large liver angiomyolipoma causing IVC obstruction [CT] and one patient was incidentally found to have ventricular tachycardia. Conclusion: Awareness of these unusual findings is important as some TSC patients go through unnecessary invasive investigations due to lack of awareness of the association. On the other hand, some of these findings may require regular monitoring and early intervention.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1105 P3-89 Under Pressure E. Wastnedge, M. Dhillon, K. Tallur. NHS Lothian, United Kingdom Objective: Idiopathic intracranial hypertension (IIH) is a condition characterised by raised intracranial pressure on LP, normal CSF analysis, papilloedema, and normal brain parenchyma on neuroimaging. In adults, it classically affects women of childbearing age with raised BMI however the paediatric demographic has not been fully characterised. The study aims to identify the prevalence, presentation and treatment outcomes in the paediatric population in Edinburgh. Methods: The paediatric neurology department, in the Royal hospital for Sick Children in Edinburgh
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kept a record of all children presenting with IIH from 2009-2016. Twenty-two cases were identified and data on demographics, presenting symptoms, signs, investigations, treatment and outcomes was extracted retrospectively from “TRAK”- the hospital computer system. This data was collated and analysed using Microsoft Excel. Results: Mean age of presentation was 7.5 years. There was no gender bias with a 1:1 male to female ratio. Only 9% patients had raised BMI. Half of patients were picked up incidentally on routine ophthalmology exam. Most common symptoms were headache (59%) and blurred vision (14%). On examination 95% had bilateral papilloedema. Mean opening pressure on lumbar puncture (LP) was 28cmH2O. 64% had normal imaging. 4 patients had Chiari type I malformations and 5 had optic nerve head drusen. Medical management was either acetazolamide (67%) or furosemide (24%). 68% experienced either ongoing symptoms of intolerable side effects from their treatment requiring medication alterations. IIH resolved in 32% of the patients, and 64% have ongoing IIH and continue to receive treatment and follow-up. Conclusion: This study demonstrates the characteristics of IIH in the paediatric population. It highlights a need for clear diagnostic guidelines for this age group. There is also the need for a consistent, evidence based treatment guideline based on a comprehensive randomised controlled trial.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1106
images], one patient had swelling of their left ring finger [photo & x-ray], one patient had swelling of the right buttock and thigh [photo & MRI], two patients had glossal hamartoma [photos], one patient had a large liver angiomyolipoma causing IVC obstruction [CT] and one patient was incidentally found to have ventricular tachycardia. Conclusion: Awareness of these unusual findings is important as some TSC patients go through unnecessary invasive investigations due to lack of awareness of the association. On the other hand, some of these findings may require regular monitoring and early intervention.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1105 P3-89 Under Pressure E. Wastnedge, M. Dhillon, K. Tallur. NHS Lothian, United Kingdom Objective: Idiopathic intracranial hypertension (IIH) is a condition characterised by raised intracranial pressure on LP, normal CSF analysis, papilloedema, and normal brain parenchyma on neuroimaging. In adults, it classically affects women of childbearing age with raised BMI however the paediatric demographic has not been fully characterised. The study aims to identify the prevalence, presentation and treatment outcomes in the paediatric population in Edinburgh. Methods: The paediatric neurology department, in the Royal hospital for Sick Children in Edinburgh
e213
kept a record of all children presenting with IIH from 2009-2016. Twenty-two cases were identified and data on demographics, presenting symptoms, signs, investigations, treatment and outcomes was extracted retrospectively from “TRAK”- the hospital computer system. This data was collated and analysed using Microsoft Excel. Results: Mean age of presentation was 7.5 years. There was no gender bias with a 1:1 male to female ratio. Only 9% patients had raised BMI. Half of patients were picked up incidentally on routine ophthalmology exam. Most common symptoms were headache (59%) and blurred vision (14%). On examination 95% had bilateral papilloedema. Mean opening pressure on lumbar puncture (LP) was 28cmH2O. 64% had normal imaging. 4 patients had Chiari type I malformations and 5 had optic nerve head drusen. Medical management was either acetazolamide (67%) or furosemide (24%). 68% experienced either ongoing symptoms of intolerable side effects from their treatment requiring medication alterations. IIH resolved in 32% of the patients, and 64% have ongoing IIH and continue to receive treatment and follow-up. Conclusion: This study demonstrates the characteristics of IIH in the paediatric population. It highlights a need for clear diagnostic guidelines for this age group. There is also the need for a consistent, evidence based treatment guideline based on a comprehensive randomised controlled trial.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1106