title: False diagnosis of papilloedema and idiopathic intracranial hypertension.
abstract: The diagnosis of idiopathic intracranial hypertension (IIH) relies heavily on the appearance of the optic disc. We report eighteen children referred to us over a 3 year period with disc swelling and suspected IIH. Following a tertiary ophthalmological review, papilloedema was excluded in ten with buried drusen, disc crowding, pseudopapilloedema, or misinterpretation of normal appearances. In these ten children, five had a mean opening pressure on lumbar puncture of 27.2 cm H2O, range 19-32, which was significantly lower than those with IIH (37.5 cm H2O, range 29-47; p<0.01). We conclude that diagnosis of IIH is difficult, and that more precisely defined criteria for assessment and diagnosis are needed.
authors.affiliation: Department of Paediatric Neurology, Sheffield Children's Hospital, Sheffield, S10 5DD, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mishra
authors.forename: S R
authors.initials: SR
authors.lastname: Mordekar
authors.forename: I G
authors.initials: IG
authors.lastname: Rennie
authors.forename: P S
authors.initials: PS
authors.lastname: Baxter
mesh_terms: D000293:Adolescent; D015170:Cerebrospinal Fluid Pressure; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003941:Diagnostic Techniques, Ophthalmological; D005189:False Positive Reactions; D006801:Humans; D010211:Papilledema / Q000175:diagnosis* / Q000209:etiology; D011559:Pseudotumor Cerebri / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies