Neurologic Manifestations of Ependymoma Clinical Presentation
- Author: Subrata Ghosh, MD, MBBS, MS; Chief Editor: Stephen A Berman, MD, PhD, MBA more...
Presenting features are insidious and progressive in nature.
- Nausea and vomiting (80%) is the most common presenting symptom, secondary to increased intracranial pressure.
- Headache (60%), due to the local effect of pressure or increased intracranial pressure, is usually worse in the morning.
- Change in behavior (50%) includes lethargy, irritability, diminished social interaction, and loss of appetite (prevalent in younger children).
- Difficulty with balance (30%) reflects cerebellar involvement or mass effect.
See the list below:
- Papilledema (60%)
- Ataxia (45%)
- Nystagmus with or without gaze palsy (40%)
- Lower cranial nerve palsies (10%)
- Apraxia or hemiparesis (20%)
- Increase in head circumference in children younger than 2 years (10%)
No particular genetic or molecular marker or familial predisposition has been identified for this tumor type. In one series, only a few ependymomas were reported to be hyperdiploid or tetraploid.
- Other diagnostic considerations:
- Other brain tumors (astrocytoma, medulloblastoma, oligodendroglioma)
- Meningitis and encephalitis can be readily differentiated by their more abrupt onset, associated fever, or signs of meningeal irritation.
- Differentiation from other types of brain tumors (astrocytoma, medulloblastoma, oligodendroglioma) is radiological and pathological.
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