Viruses were not Found to be Involved in Pediatric Idiopathic Intracranial Hypertension Cases

Objectives: Idiopathic intracranial hypertension (IIH) is a disorder defined by clinical criteria produced by increased intracranial pressure (ICP), elevated ICP, normal cerebrospinal fluid (CSF) composition, and no other identified cause of intracranial hypertension.

Although many risk factors of IIH have been identified, the pathogenesis remains unknown.

Previos studies have reported cases of viral-induced intracranial hypertension who had typical clinical presentation of IIH- but with abnormal CSF analysis.

Based on reports of PCR proven viral CNS infection with normal CSF analysis , the aim of the current study is to investigate the possible role of CNS viral infections in the pathogenesis of IIH.

Methods: In a prospective multicenter CSF samples of pediatric patients (0-18 years) were collected, opening pressure was measured and CSF analysis was performed. Additional data was collected including clinical presentation, imaging and ophthalmic findings. Using the ALLPLEX tm meningitis panel, a real-time polymerase chain reaction (PCR) was performed to test the presence of 12 viruses that are known to cause CNS infections.

Results: 50 CSF samples of pediatric patients were collected, of them 30 diagnosed with IIH, 20 cases served as controls.

In the IIH group 1 patient (3.3%) was positive for EBV, while in the control group 1 patient (5%) was positive for Human Herpes 7.

Conclusion: IIH was not found to be correlated with the presence of viruses in CSF, as compared to control subjects without IIH. The pathogenesis remains unknown.
Further studies are required to determine the possible corrleation with non infectious inflammatory reactions.