Benign intracranial hypertension and facial diplegia

Benign intracranial hypertension (BIH) may occasionally be associated with false localizing cranial nerve palsies. Abducens nerve palsies reportedly occur in 10% to 60% of patients with BIH, whereas other cranial nerve palsies occur much less frequently. We treated a woman with benign intracranial hypertension and facial diplegia who showed complete resolution of her cranial nerve palsies after control of her elevated intracranial pressure with a lumboperitoneal shunt. The pathophysiologic course of cranial nerve palsies in patients with BIH is uncertain but in most cases probably represents a nonspecific pressure-related phenomenon, as was clearly demonstrated in this patient. The clinical association of BIH and facial diplegia has not, to our knowledge, been reported previously.