PT - JOURNAL ARTICLE AU - Ayman Alboudi AU - Emily C Johnson TI - Unusual presentation of idiopathic intracranial hypertension AID - 10.1136/bcr-2020-234741 DP - 2020 May 01 TA - BMJ Case Reports PG - e234741 VI - 13 IP - 5 4099 - http://casereports.bmj.com/content/13/5/e234741.short 4100 - http://casereports.bmj.com/content/13/5/e234741.full SO - BMJ Case Reports2020 May 01; 13 AB - 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.