Idiopathic Intracranial Hypertension (IIH), a case study

Background and Aim : IIH is an idiopathic disease with increased pressure of CSF without secondary cause. It is observed in all age groups, especially obese young women and children with symptoms of vision loss, headache, double vision, papilledema. Here we reported a 32-year-old female case in Bu-Ali Hospital of Qazvin, Iran.Methods : The patient had cold symptoms (22 days before admission), severe progressive headache and neck pain, followed by double vision and frequent vomiting and upper limb paresthesia but no fever and meningitis symptoms. Complete paralysis in horizontal movements of right eye with left environmental facial paresis and two-way papilledema in ophthalmoscopy were diagnosed. Power and tone of organs and reflexes were normal and +1 respectively, also plantar reflexes were normal without Babinski. No findings on paraclinics and OP=34cmH2O in Lumbar Puncture(LP) with decreased protein in CSF. Considering high ICP, Acetazolamide 250mgIV/BD was prescribed. Pain was relieved After LP and discharging of CSF, followed by the full recovery of eye movement in 3 days. In CSF analysis of the third day OP=18cmH₂O. The patient was discharged with full recovery. Polycystic ovary syndrome (PCOS) was reported in ultrasound findings.Results : In neurological references, patients with IIH have ophtolmoparesis in outward movements but widespread paralysis of cranial nerves is rare and responded well to treatment.Conclusion : In neurological references, patients with IIH have ophtolmoparesis in outward movements but widespread paralysis of cranial nerves is rare and responded well to treatment.

Keywords:

Idiopathic Intracranial Hypertension , papilledema , headache