Optic nerve glioma history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Symptoms of optic nerve glioma include proptosis, unilateral or bilateral visual impairment, involuntary eyeball movement, squinting, vomiting, irritability, poor feeding , seizures, deficits in muscle tone and strength, daytime sleepiness, decreased memory and brain function, weight loss, delayed growth and loss of appetite.

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]

Common symptoms of optic pathway gliomas include:

• Proptosis
• Unilateral or bilateral visual impairment.
• Optic nerve gliomas may present with symptoms of the obstructive hydrocephalus, which includes:
  • Vomiting
  • Sleepiness
  • Poor feeding
  • Irritability
  • Seizures
  • Deficits in muscle tone and strength

Other less common symptoms are:

• Involuntary eye ball movement
• Squinting
• Hypothalamic gliomas may present with symptoms of the diencephalic syndrome, which includes:
  • Daytime sleepiness
  • Decreased memory and brain function
  • Delayed growth
  • Loss of appetite and loss of weight
• Precocious puberty– Due to involvement of hypothalamic-pituitary-gonadal axis precocious puberty may occur in 39 % of children with chiasmal optic nerve gliomas and NF-1.^[2] In 10 to 20 percent of patients with optic pathway gliomas endocrinopathies due to hypothalamic extension are present.

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