Idiopathic Intracranial Hypertension and Facial Palsy: Case Report and Review of the Literature

We present the case of an 11-year-old obese girl who presented with idiopathic intracranial hypertension affecting first the lateral abducens nerve. She received acetazolamide, but 5 days later she developed lateral, peripheral facial palsy. Imaging evaluation was normal, which primarily excluded ce...

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Bibliographic Details
Published in:Journal of child neurology 2010-12, Vol.25 (12), p.1529-1534
Main Authors: Tzoufi, Meropi, Makis, Alexandros, Grammeniatis, Vasilios, Nakou, Iliada, Exarchakos, Georgios, Asproudis, Ioannis, Zikou, Anastasia, Argyropoulou, Maria, Siamopoulou-Mavridou, Antigone
Format: Article
Language:English
Subjects:
Abducens nerve
acetazolamide
Case reports
Child
Corticoids
Facial Nerve Diseases - drug therapy
Facial Nerve Diseases - etiology
Female
Humans
Hypertension
Obesity
Paralysis
Prednisolone
Pseudotumor Cerebri - complications
Pseudotumor Cerebri - drug therapy
Reviews
Sinus
Thrombosis
Treatment Outcome
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Summary:We present the case of an 11-year-old obese girl who presented with idiopathic intracranial hypertension affecting first the lateral abducens nerve. She received acetazolamide, but 5 days later she developed lateral, peripheral facial palsy. Imaging evaluation was normal, which primarily excluded cerebral venous thrombosis and sustained the initial diagnosis. Despite some complicating factors (obesity, elevated intracranial pressure), prednisolone was administered for a short-term period to counteract the facial palsy. Ophthalmological residuals resolved within almost 1.5 months, while facial palsy receded after 4 months. Peripheral facial palsy is an extremely rare, but not unknown condition in idiopathic intracranial hypertension. As a symptom, it should be investigated thoroughly, primarily to exclude cerebral venous sinus thrombosis, before it can be attributed to idiopathic intracranial hypertension. As far as treatment is concerned, corticosteroids can be added to the initial treatment with acetazolamide, without worsening already elevated intracranial hypertension or ophthalmologic findings.
ISSN:0883-0738
1708-8283
DOI:10.1177/0883073810375849