Mononeuropathia multiplex and idiopathic intracranial hypertension

A young obese woman with menstrual irregularities presented with bilateral papilledema, abducens nerve paresis, visual obscurations and severe headache. Neuroimaging studies were normal but CSF opening pressure was elevated. The diagnosis of idiopathic intracranial hypertension was made. Insertion of a shunt quickly alleviated the symptoms. A few weeks later the patient developed a left femoral nerve paresis and an ulnar nerve paresis on the right. Electrodiagnostic tests confirmed the diagnosis of mononeuropathia multiplex. Bone marrow histology showed a vasculitis. We hypothesize that the vasculitis is underlying both, idiopathic intracranial hypertension and mononeuropathia multiplex.