Endocrine Abstracts

Introduction: Raised intracranial pressure is a well-documented complication of obesity in the adult population, but this remains under-recognised in children and young people. The pathophysiology for this association remains unclear, but the complications of raised intracranial pressure can be devastating including potential visual loss. Therefore, the aim of our study was to investigate this link in children and young people.

Method: Retrospective data collection from individuals diagnosed with idiopathic intracranial hypertension (IIH) at a tertiary children’s hospital over two years.

Results: 18 patients were identified with a mean age at diagnosis of 11 years (± 3.3SD; range: 6 to 15 years). 61% were female. The mean BMI was 30.3 kg/m² (range: 13.9 to 58.2 kg/m²) and the mean BMI SDS was +2.5 (range: -1.24 to +4.46). 72.2% of individuals had BMI SDS > 2. Headaches and eye signs (visual disturbances or ophthalmology findings) were the presenting symptoms and signs for 12 patients. 3 patients did not experience any symptoms and were found to have papilloedema on routine optician review. Diagnosis for all patients was via a lumbar puncture with 61% requiring theatre or admission to the radiology department for it to be successful. 82% of these required general anaesthetic. 83% of patients were treated medically and 11% required long-term neurosurgical interventions (ventriculoperitoneal and ventriculoatrial shunts). 6% did not require treatment.

Conclusion: These results show a clear association between IIH and obesity and highlight that being female may be a risk factor. IIH is not a well-recognised complication in paediatrics and therefore may not always be considered when health professionals review an individual with childhood obesity. Awareness to screen for IIH is essential so that permanent visual loss can be prevented.