Facial palsy and fallopian canal expansion associated with idiopathic intracranial hypertension.

OBJECTIVE

Describe neurotologic findings associated with idiopathic intracranial hypertension (IIH).

STUDY DESIGN

Retrospective.

SETTING

Tertiary referral center.

PATIENTS

Case of IIH (>250 mm water) presenting with unilateral facial palsy and enlargement of the fallopian canal on computed tomography and magnetic resonance imaging.

INTERVENTION(S): Oral acetazolamide, corticosteroids, and cerebrospinal fluid drainage.

MAIN OUTCOME MEASURE(S): Intracranial pressure measurement, cranial nerve examination, audiometry, and symptom assessment.

RESULTS

Audiometry revealed asymmetric sensorineural hearing loss. Enlargement of the fallopian canal with cerebrospinal fluid was evident on imaging studies. Partial resolution of IIH symptoms was achieved.

CONCLUSION

IIH is an enigmatic disease entity. Increased intracranial pressure usually presents with headache and pulsatile tinnitus and is occasionally associated with cranial neuropathies. Abducens palsy is most common, producing diplopia. Cranial nerve involvement is often asymmetric, producing false localizing signs. Facial paralysis is an uncommon sequela of IIH. Treatment of IIH consists of reducing intracranial pressure. Corticosteroids are recommended for treatment of facial paralysis.