Seizures as the Cardinal Manifestation of Idiopathic Intracranial Hypertension: A Case Report

Abstract

Idiopathic intracranial hypertension (IIH) conventionally presents with features like headache, visual obscuration, diplopia and tinnitus. We present a case of a middle-aged male patient with headache and visual complaints and concurrent drug-resistant right focal seizures. Imaging revealed the presence of a left petrous bone defect with temporal lobe encephalocele with other features suggestive of IIH. Resolution of the symptoms was obtained after placement of theco-peritoneal shunt. Focal seizures in IIH are a rare phenomenon, precipitated by parenchymal herniation through eroded bony defects producing encephaloceles leading to tissue traction and ictal focus formation. In evaluation for drug-resistant temporal lobe epilepsy, IIH-induced encephalocele formation should be carefully considered.