Rickets presenting as pseudotumour cerebri and seizures

Vitamin D deficiency rickets presenting as pseudotumor cerebri

“…However, the infant had presented with hypocalcemic convulsions in contrast to our patient, who had irritability and bulging fontanelle. [5] De Jong et al and Hanafy et al have described infants who had pseudotumor cerebri and nutritional rickets. However, in contrast to our case, the bulging fontanelle If symptoms or signs present, they may only reflect those of generalized intracranial hypertension or papilledema; normal mental status Documented elevated intracranial pressure (age-appropriate) measured in the lateral decubitus position; neonates: >76 mm H 2 O, age 1-18 years: >280 mm H 2 O Normal CSF composition except in neonates, who may have up to 19 WBC/mm 3 , if 0-28 days, and up to 9 WBC/mm 3 if between 29 and 56 days old; the protein may be as high as 150 mg/dl No evidence of hydrocephalus, mass, structural or vascular lesion on MRI, with and without contrast, and MR venography; narrowing of the transverse sinuses is allowed Cranial nerve palsies allowed, if there is of no other identifiable etiology and they improve with reduction in cerebrospinal fluid pressure or resolution of other signs and symptoms of intracranial hypertension No other identified cause of intracranial hypertension in their patients persisted for several months even after starting treatment.…”

Vitamin D Deficiency and Nutritional Rickets in Children

“…Few children present clinically in stage I as the majority who later present with rickets pass through this phase without developing symptomatic hypocalcemia. Pseudotumor cerebri [94] and cataracts, probably due to hypocalcemia, have been reported in a young infant with rickets [95]. It has been suggested that symptomatic hypocalcemia in infants with vitamin D deficiency might be precipitated by an acute illness [96], in which there is a release of intracellular phosphate [97].…”

Hypophosphatasia associated with Pseudotumor cerebri and respiratory insufficiency

“…rickets were reported, 5,6,7 but there is no report PTC associated with hypophosphatasia. The mechanism responsible for this process is unknown.…”