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Neurological Manifestations as Presenting Feature of Osteopetrosis in Children; A Review of 11 Cases

Author(s):
Saeed  SaeediniaSaeed Saeedinia1, Mohammad  JaafariMohammad Jaafari2, Farideh  NejatFarideh Nejat3,*, Naghmeh  PourmandNaghmeh Pourmand1, Mostafa  El KhashabMostafa El Khashab4
1Department of Neurosurgery, Tehran University of Medical Science, Iran
2Department of neurosurgery, Iran University of Medical Sciences, Iran
3Department of Neurosurgery, Childrens Hospital Medical Center, Tehran University of Medical Science, nejat@sina.tums.ac.ir, Iran
4Department of Neurosurgery, Hackensack University Medical Center, United States of America


Archives of Neuroscience:Vol. 1, issue 1; 21-5
Published online:Mar 31, 2014
Article type:Research Article
Received:Jan 02, 2013
Accepted:Apr 15, 2013
How to Cite:Saeed SaeediniaMohammad JaafariFarideh NejatNaghmeh PourmandMostafa El KhashabNeurological Manifestations as Presenting Feature of Osteopetrosis in Children; A Review of 11 Cases.Arch Neurosci.1(1):21-5.https://doi.org/10.5812/archneurosci.10010.

Abstract

Background:

Osteopetrosis is a rare congenital disorder characterized by the malfunction of osteoclast cells resulting in increased bone density and adverse complications such as bone marrow insufficiency, bone fragility, and neurological symptoms subsequent to increased cortical thickness of the skull.

Objectives:

We studied neurologic manifestation of the disease, the main complaints that resulted in the diagnosis, the management and outcome during the follow up period.

Patients and Methods:

This study comprised of children having neurological symptoms as their initial presentation of osteopetrosis that were referred to Children Medical Center Hospital in Tehran from June 2001 to 2011.

Results:

Intracranial hypertension was the first presentation of osteopetrosis in 11 of the children; 7 patients showed signs and symptoms of hydrocephalous, and 4 had pseudotumor cerebri. In addition, visual disturbance was also a common finding. All patients aged 2 or more (5 children) complained of headache, and 2 of the patients (18%) had facial palsy. During the follow-up (2.1 1.9 years), 3 patients (27%) died due to bone marrow insufficiency and sepsis.

Conclusion:

The diagnosis of osteopetrosis with the aid of neurological presentation is uncommon and neurological complications are usually found during the follow-ups. All of our patients presented with signs and symptoms of intracranial hypertension and the diagnosis of osteopetrosis was established. After a trail of investigations, this observation considers the importance of extensive evaluation of a child with a new onset hydrocephalus to prevent further serious complications.

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