Benign intracranial hypertension: an unrecognized complication of oral corticosteroid therapy

Background. - Benign intracranial hypertension is due to an increased intra cranial pressure of unknown cause. The initial symptoms, complications and associations with medical conditions are discussed. Case report. - A 6-year-old girl developed symptoms of benign intracranial hypertension following reduction of oral corticosteroid therapy. Laboratory studies and head-computed tomographic scan were normal. Examination of the optic discs showed bilateral papilledema and the cerebrospinal fluid press ure was increased. The patient was given prednisone therapy 1 mg/kg daily i nitially, associated with acetazolamide, and removal of 25 mL of cerebrospi nal fluid. All the symptoms resolved and the treatment was gradually decrea sed. The child developed no further visual failure. Conclusion. - Benign intracranial hypertension with risk of permanent visua l loss is a complication underrecognized in children. All patients receivin g large doses of the corticosteroids who complain of headache or blurring v ision, particularly following a reduction of corticosteroid dosage, should have an ophtalmoscopic examination to exclude this complication. (C) 1999 E lsevier, Paris.