Seizure as the presenting sign of idiopathic intracranial hypertension.
Aman Pal SayalManav V VyasJonathan A MicieliPublished in: BMJ case reports (2022)
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.
Keyphrases
- magnetic resonance
- optic nerve
- blood pressure
- weight loss
- end stage renal disease
- temporal lobe epilepsy
- resting state
- white matter
- ejection fraction
- contrast enhanced
- newly diagnosed
- emergency department
- chronic kidney disease
- magnetic resonance imaging
- public health
- bariatric surgery
- healthcare
- case report
- prognostic factors
- functional connectivity
- peritoneal dialysis
- high throughput
- optical coherence tomography
- type diabetes
- computed tomography
- ultrasound guided
- adipose tissue
- cerebral ischemia
- subarachnoid hemorrhage
- blood brain barrier