Combined paralysis of the abducens and facial nerves following idiopathic intracranial hypertension.

INTRODUCTION

Idiopathic intracranial hypertension (IIH) is a clinical phenomenon that reflects an increase in intracranial pressure in the brain with normal parenchyma and no signs of ventriculomegaly, malignancy, infection, or any space-occupying lesion. Generally, this disease is associated with symptoms such as headache, transient visual obscurations (unilateral or bilateral darkening of the vision typically seconds), intracranial noise, diplopia, blurring of vision, abducens nerve palsies, and unilateral or bilateral facial nerve paresis (which is a very rare complication of this disease that has been reported in some studies).

CASE PRESENTATION

An 8-year-old boy with a history of bilateral frontal headache for 2 weeks, right ear pain, vomiting, and intermittent fever, who had received antibiotics and analgesics with improvement of ear pain and continuation of headache, presented to this center. In the initial neurological examinations, bilateral papilledema and right-sided 6th and 7th cranial nerve palsy (peripheral) were observed. After performing LP and CT scan and MRV for the patient, a diagnosis of pseudotumor cerebri was made and he was treated with acetazolamide, prednisolone, and topiramate. He was discharged after 10 days.

CONCLUSION

Although pseudotumor cerebri is less common in children than adults and obesity and female gender are considered as risk factors for this disease, it is not usually associated with involvement of the 6th and 7th cranial nerves. However, sometimes this disease can occur in children without any risk factors and with less common involvement of the 6th and 7th cranial nerves.