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Benign Intracranial Hypertension Associated With Budesonide Treatment in Children With Crohn's Disease

Pediatric Gastroenterology Service

Nathan Watemberg, MD

Pediatric Neurology Unit E. Wolfson Medical Center, Holon Tel Aviv University Sackler School of Medicine, Tel Aviv

Hanoch Hager, MD

Pediatric Gastroenterology Clinic Haemek Hospital, Afula

Yoram Bujanover, MD

Pediatric Gastroenterology Service

Ami Ballin, MD

Department of Pediatrics

Tally Lerman-Sagie, MD

Pediatric Neurology Unit E. Wolfson Medical Center, Holon Tel Aviv University Sackler School of Medicine Tel Aviv, Israel

Oral budesonide in adult studies is a potent corticosteroid with decreased systemic bioavailability and an improved adverse effect profile in comparison with prednisone. It has recently been introduced for the treatment of inflammatory bowel disease in Europe, Canada, and Israel. Benign intracranial hypertension has rarely been associated with corticosteroid therapy but has not been reported in association with budesonide therapy. Three adolescents with Crohn's disease and poor nutritional status developed benign intracranial hypertension while receiving oral budesonide. All three patients had previously received multiple courses of prednisone during the course of their disease, without developing intracranial hypertension. Benign intracranial hypertension resolved after medication withdrawal and did not recur with subsequent use of prednisone. Evaluation for benign intracranial hypertension should be considered in patients with inflammatory bowel disease who develop headache while receiving oral budesonide. This side effect may be associated with poor nutritional status. (J Child Neurol 2001;16:458-461).

Journal of Child Neurology, Vol. 16, No. 6, 458-461 (2001)
DOI: 10.1177/088307380101600617


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