This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (12)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pediatrics  • Pediatrics, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Patrick W. Mason, MD, PhD; Nicolas Krawiecki, MD; Lillian R. Meacham, MD

Arch Pediatr Adolesc Med. 2002;156:887-892.

Background  Obesity and attention difficulties are known complications following surgical treatment for craniopharyngioma. Treatments to date have been largely disappointing.

Objective  To examine the use of the central nervous system stimulant dextroamphetamine sulfate to regulate appetite and subsequent weight gain in children treated for craniopharyngioma.

Setting  A multidisciplinary clinic specializing in pediatric brain tumors.

Patients  Five consecutive patients with significant weight gain and poor attention following surgical treatment for craniopharyngioma were selected for the study.

Intervention  Children enrolled in the study were treated with dextroamphetamine, and growth, laboratory, and behavioral assessments were conducted for 24 months.

Results  Mean ± SD body mass index (weight in kilograms divided by height in meters squared) increased from 21 ± 3.5 before the operation to 32 ± 2.8 by the start of the protocol. Body mass indices remained stable throughout the protocol. No changes were observed in insulin levels or caloric intake, but the children were more active when taking dextroamphetamine. Parents noted a significant improvement in hyperactivity (mean ± SD, 1.2 ± 0.4 to 0.6 ± 0.2; P = .05), scored with the Conners Parent and Teacher Rating Scales. Teachers noted a similar improvement.

Conclusions  During dextroamphetamine treatment, weight gain stabilized in children who had experienced obesity following surgical resection for craniopharyngioma. In addition, parents and teachers noted significant improvements in children's overall activity and attention. Further studies are needed to determine if the improvements are stable and if earlier intervention can prevent the initial obesity.

From the Inova Fairfax Hospital for Children, Fairfax, Va (Dr Mason); and the Divisions of Pediatric Neurology (Dr Krawiecki) and Pediatric Endocrinology (Dr Meacham), Emory University, Atlanta, Ga.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Distal gastric bypass surgery for the treatment of hypothalamic obesity after childhood craniopharyngioma
Schultes et al.
Eur J Endocrinol 2009;161:201-206.
ABSTRACT | FULL TEXT  

Reductions in Basal Metabolic Rate and Physical Activity Contribute to Hypothalamic Obesity
Shaikh et al.
J. Clin. Endocrinol. Metab. 2008;93:2588-2593.
ABSTRACT | FULL TEXT  

Obesity in Patients with Craniopharyngioma: Assessment of Food Intake and Movement Counts Indicating Physical Activity
Harz et al.
J. Clin. Endocrinol. Metab. 2003;88:5227-5231.
ABSTRACT | FULL TEXT  

Octreotide Therapy of Pediatric Hypothalamic Obesity: A Double-Blind, Placebo-Controlled Trial
Lustig et al.
J. Clin. Endocrinol. Metab. 2003;88:2586-2592.
ABSTRACT | FULL TEXT