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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review focuses on the features of pseudotumor cerebri in the pediatric age group. There is no sex predilection in children, and obesity does not appear to be an important factor. Infants and young children may present with irritability, apathy, or somnolence, rather than headache. Dizziness and ataxia may also occur. Papilledema is infrequently noted in pediatric patients if the fontanelles are open or the sutures are split. Pre-adolescents appear more likely than adults or adolescents to have manifestations of their pseudotumor cerebri other than headache and papilledema, including lateral rectus pareses, vertical strabismus, facial paresis, back and neck pain. Among the etiologies that are particularly pertinent to children are tetracycline therapy, malnutrition or renutrition, and the correction of hypothyroidism. Children with pseudotumor cerebri are at risk for visual loss and their visual function must be closely monitored. Surgical intervention is imperative when vision is threatened.
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PMID:Pediatric pseudotumor cerebri (idiopathic intracranial hypertension). 147 50

Eighty patients with benign intracranial hypertension (BIH) (76 females, 4 males, age range 15-54 years) were studied. Endocrine changes (pregnancy-17, obesity-16, dysmenorrhea-15, hyperthyroidism-7, etc.) were the most common cause of BIH (72.5%-58 from 80). Besides general sings of intracranial hypertension (papilledema-80, headache-76, nausea-47, dizziness-43, obnubilations-39), 36 (45%) patients had visual problems. After treatment complete recovery took place in 48 patients, non-significant residual changes persisted in 16 patients, main symptoms of BIH persisted in 16 patients. Papilledema regressed completely in 52 patients, post-papilledematous discoloration of optic disks or optic atrophy were discovered in 12 patients.
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PMID:[The syndrome of benign intracranial hypertension]. 757 31

Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, is a syndrome characterized by an elevated intracranial pressure in the absence of a focal lesion, infective process, or hydrocephalus. New onset IIH may present to the emergency department in a variety of ways. To describe the etiologic associations and clinical features in this disorder, we performed a retrospective analysis of consecutive emergency department patients with new onset IIH during the calendar years 1987-1996. A total of 52 patients met all study criteria. The mean patient age was 27+/-8.9 years; the female-to-male ratio was 7:1. An etiologic association could be identified in 85% of cases and included obesity, hypertension, drugs, endocrine, and systemic disorders. Headache was a dominant complaint in most patients (48/52) and associated with dizziness, nausea, and/or visual complaints. Fourteen patients (27%) were not diagnosed on their initial ED visit and were more likely to have atypical clinical features (71% vs. 24%; P = .004). Atypical features included paraesthesias, neck/back pain, unilateral headache, vertigo, and nystagmus. Papilledema, the ophthalmoscopic hallmark of IIH, was not detected initially in 11 patients (21%). These results suggest that IIH is a relatively uncommon neurological illness that may have a variety of causes. The emergency department diagnosis may be complicated by atypical clinical features and a lack of detectable papilledema.
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PMID:Emergency department presentation of idiopathic intracranial hypertension. 1053 May 26

We report two cases of bilateral papilledema in young women. The first patient was 15 years old and had experienced headaches and vomiting for one month, but no visual loss. Cerebral tomodensitometry results were normal, but lumbar puncture showed increased pressure and normal biology. Benign intracranial hypertension was diagnosed. Recent treatment with minocycline for acne vulgaris was the only etiology. Papilledema was totally regressed at 6 weeks, after interruption of the antibiotic treatment. A prescription of acetazolamide was added for a short period of 10 days. The second patient, aged 29 years, presented bilateral papilledema with severe visual loss, with vision limited to light perception with mydriasis of the right eye. Lumbar puncture was not indicated because of a hypophyseal microadenoma revealed on MRI investigation. No other associated abnormalities were observed, in particular, no cerebral sinus thrombosis. Corticotherapy using prednisolone for 72 hours had no clinical effect. Fast visual recovery was obtained with intravenous acetazolamide therapy and was completely resolved at 2 months. Right visual field defects persisted. Minocycline and obesity are recognized as precipitating factors in pseudotumor cerebri syndrome. The literature advocates consideration of surgical treatment by optic nerve sheath fenestration if antiedematous treatment has no effect and the eye is nearly blind.
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PMID:[Bilateral papilledema in young women: two case reports of benign intracranial hypertension?]. 1247 53

Idiopathic intracranial hypertension is an important cause of headaches in the pediatric population and can lead to permanent blindness if not diagnosed in a timely manner. The aim of this study was to characterize the incidence of papilledema and obesity in children with idiopathic intracranial hypertension. We retrospectively analyzed 27 patients followed at The University of Texas Houston Pediatric Neurology Clinic. Papilledema was absent in 13 (48%) patients. The majority of our patients were nonobese (70%). Our results are contrary to the current medical practice of associating papilledema and obesity with idiopathic intracranial hypertension in childhood and highlight the importance of revised diagnostic criteria in this population needed to detect and manage this condition.
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PMID:Incidence of papilledema and obesity in children diagnosed with idiopathic ''benign'' intracranial hypertension: case series and review. 2035 37