RT Journal Article
SR Electronic
T1 Seizure as the presenting sign of idiopathic intracranial hypertension
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e246604
DO 10.1136/bcr-2021-246604
VO 15
IS 1
A1 Aman Pal Sayal
A1 Manav Vyas
A1 Jonathan A Micieli
YR 2022
UL http://casereports.bmj.com/content/15/1/e246604.abstract
AB A 38-year-old man presented to the emergency room with a new generalised tonic-clonic seizure. He also complained of headaches, and brain MRI/magnetic resonance venography (MRV) showed an anterior left temporal encephalocoele with gliosis and brain parenchyma herniating into the left foramen ovale. Ophthalmic examination revealed bilateral optic disc oedema and his lumbar puncture confirmed an elevated opening pressure of 48 cm of water. He was diagnosed with idiopathic intracranial hypertension (IIH) and his papilloedema resolved with weight loss and acetazolamide. Raised intracranial pressure (ICP) can be associated with encephalocoeles and lead to seizures. It is important to screen for papilloedema in these patients as they are at risk for permanent vision loss. This was a unique case in which IIH was diagnosed only after a seizure due to an encephalocoele, which was likely related to chronically undetected raised ICP.