If you have a pediatric patient with pseudotumor cerebri, there’s a possible cause for the condition that you may not have known about.

Researchers gave full ocular examinations to three children receiving recombinant growth hormone (rhGH). Once they identified papilledema, they performed lumbar puncture and imaging with either magnetic resonance imaging or computerized tomography. The rhGH was discontinued in all the children.

Visual acuity and evaluation of the optic nerve for resolution of papilledema were followed at each examination. In all three cases, the papilledema resolved when the rhGH was stopped and acetazolamide or prednisone was administered. Visual acuity was unchanged in one child, decreased by two to three lines in the second child, and was inconsistent in the third. One child required a ventriculoperitoneal shunt for persistently elevated intracranial pressure.

The researchers say there appears to be a relationship between initiation of rhGH and development of pseudotumor cerebri, and they recommend a complete ophthalmic examination if a child taking the hormone reports headache or visual disturbance.