Idiopathic intracranial hypertension (IIH) characterizes by headaches and may lead to irreversible visual loss. Data in literature is controversial regarding the effects of gender, puberty and cause of IIH on the severity of the condition in children. Moreover, there is no accepted pediatric follow-up protocol for children with IIH. Our aim was to investigate whether multidisciplinary continuous management improves prognosis in different cohorts of patients with IIH.
We analyzed data from computerized medical charts of pediatric IIH in all three Jerusalem`s medical centers. Recurrence of IIH-related ER-admissions and hospitalizations were used as a primary outcome and comparison of continuous management efficacy in a tertiary center versus community clinic or no follow up was analyzed.
Between 2010 and 2017, we identified 90 children with IIH with average follow-up of 19 months. Forty six percent had a continuous follow-up at a tertiary center, compared with 26.7%, 18.3% and 8.3% with none, sparse or after-recurrence tertiary follow-up, respectively.
Among patients who had continuous follow-up at a tertiary center there was a lower rate of IIH-related ER re-admissions and re-hospitalizations (17.9% and 14.3%, respectively) compared with patients who had follow-up at community clinics or lack of follow up (43.8% and 31.3%, p<0.05). Interestingly, among ER re-admissions as well as re-hospitalizations, there was significantly higher rate of females. We didn`t find any effect of puberty or cause of IIH on admission rate.
In summary, our data supports that continuous multidisciplinary follow-up of children with IIH in a tertiary medical center is associated with better outcome.
