Increased intracranial pressure in a case of pediatric multiple sclerosis.
A 15-year-old girl presented to our emergency department with dizziness, anorexia, nausea, and malaise. Clinical examination and magnetic resonance imaging studies showed characteristic features of multiple sclerosis. Surprisingly, a diagnostic lumbar puncture showed significant intracranial hypertension in addition to numerous oligoclonal bands, elevated immunoglobulin G index and immunoglobulin G/albumin ratio in the cerebrospinal fluid. It is proposed that a large burden of active demyelinating disease may cause increased intracranial pressure, thus providing an additional sound rationale for prompt therapeutic administration of intravenous high-dose steroids.
Department of Neurosciences, Charles P. Darby Children's Research Institute, Medical University of South Carolina, Charleston, SC, USA.
Brice J
BJ
Williams
Holly J
HJ
Skinner
Bernard L
BL
Maria
D000293:Adolescent; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000627:therapeutic use; D019586:Intracranial Hypertension / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D009460:Neurologic Examination; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid; D011241:Prednisone / Q000627:therapeutic use; D013129:Spinal Puncture
D007074:Immunoglobulin G; D043025:Oligoclonal Bands; D000068576:Interferon beta-1b; D016899:Interferon-beta; D011241:Prednisone; D008775:Methylprednisolone