Facial Palsy and Fallopian Canal Expansion Associated With Idiopathic Intracranial Hypertension

Abstract

Describe neurotologic findings associated with idiopathic intracranial hypertension (IIH). Retrospective. Tertiary referral center. Case of IIH (>250 mm water) presenting with unilateral facial palsy and enlargement of the fallopian canal on computed tomography and magnetic resonance imaging. Oral acetazolamide, corticosteroids, and cerebrospinal fluid drainage. Intracranial pressure measurement, cranial nerve examination, audiometry, and symptom assessment. Audiometry revealed asymmetric sensorineural hearing loss. Enlargement of the fallopian canal with cerebrospinal fluid was evident on imaging studies. Partial resolution of IIH symptoms was achieved. IIH is an enigmatic disease entity. Increased intracranial pressure usually presents with headache and pulsatile tinnitus and is occasionally associated with cranial neuropathies. Abducens palsy is most common, producing diplopia. Cranial nerve involvement is often asymmetric, producing false localizing signs. Facial paralysis is an uncommon sequela of IIH. Treatment of IIH consists of reducing intracranial pressure. Corticosteroids are recommended for treatment of facial paralysis.