Seasonal variation and atypical presentation of idiopathic intracranial hypertension in pre-pubertal children


Felix Distelmaier, Department of General Paediatrics, University Children's Hospital, Heinrich-Heine University Düsseldort, Moorenstr. 5, D-40225 Düsseldorf, Germany. Tel. + 49 211 811 7696, fax + 49 211 811 8757, e-mail


Idiopathic intracranial hypertension is an enigmatic disorder of elevated cerebrospinal fluid pressure. In adulthood, patients are typically obese women of childbearing age; however, in young children the clinical picture is strikingly different, indicating age-related differences in the aetiology of idiopathic intracranial hypertension. To investigate this phenomenon, we analysed the clinical details of 15 pre-pubertal children with the diagnosis of idiopathic intracranial hypertension. Evaluating the date of initial presentation, we discovered a distinct seasonal variation. Ten patients presented between November and March, thus coinciding with the typical season of paediatric viral and bacterial infections in Germany. Therefore, we suggest an association between intracranial hypertension and possibly concurrent infections in these children. Moreover, eight children presented only with ophthalmologic findings without any other obvious symptoms, raising questions regarding the incidence of undetected cases, particularly in this age group.