Optic nerve glioma history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History and Symptoms
History
Patients with optic pathway gliomas most frequently present in the first decade with a median age of 6.5 years, with slowly progressive visual loss, followed later by proptosis (although this sequence may occasionally be reversed). Acute visual loss due to hemorrhage into the tumor is uncommon. Initial signs and symptoms of malignant gliomas include severe retro-orbital pain, unilateral or bilateral vision loss, and, typically, massive swelling and hemorrhage of the optic nerve head (although disc pallor may also be observed with posterior lesions).
Common Symptoms
Decreased vision (63%) is usually evident and can be documented with visual field examination if the child is old enough. Eventually mass effects will also occur, with proptosis and even intracranial sequelae including symptoms of raised intracranial pressure, focal neurological deficits and hydrocephalus from distortion of the midbrain. Involvement of the hypothalamus may result in polyuria or polydipsia.[1] The symptoms are due to the tumor growing and pressing on the optic nerve and nearby structures. Symptoms may include:[2]
- Involuntary eyeball movement
- Outward bulging of one or both eyes
- Squinting
- Vision loss in one or both eyes that starts with the loss of peripheral vision and eventually leads to blindness
- The child may show symptoms of diencephalic syndrome, which includes:
- Daytime sleeping
- Decreased memory and brain function
- Delayed growth
- Loss of appetite and body fat