Article Text

Download PDFPDF
Case report
Unusual presentation of idiopathic intracranial hypertension
  1. Ayman Alboudi1,2 and
  2. Emily C Johnson3
  1. 1Neurology, Michigan State University, East Lansing, Michigan, USA
  2. 2Department of Neurology, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA
  3. 3Mercy Health Hauenstein Neuroscience Center, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA
  1. Correspondence to Dr Ayman Alboudi; alboudia{at}


Idiopathic intracranial hypertension typically presents with holocephalic headache associated with nausea, vomiting and bilateral papilledema. Involvement of the sixth cranial nerve is relatively common. The involvement of other cranial nerves, however, is rare in this disorder. We describe a patient with idiopathic intracranial hypertension who presented with episodic unilateral retro-orbital pain and multiple cranial nerve abnormalities without papilledema. Imaging studies excluded alternate diagnoses, and the immediate resolution of symptoms after lumbar puncture confirmed that these symptoms were due to intracranial hypertension. Atypical presentations of such a disabling yet treatable disorder is very important to recognise and address.

  • neurology
  • headache (including migraines)
  • neuroimaging

Statistics from


  • Contributors Both AA and ECJ contributed to the conception and design, acquisition and interpretation of data, drafting of the article, revising it critically for important intellectual content and final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.