Intracranial hypertension is well known to cause cranial neuropathies. The syndrome of intracranial hypertension causing limb weakness and paraesthesias is not, however, well described.^1–4 An illustrative case of intracranial hypertension causing polyradiculopathy with late or absent F-waves is presented and compared with cases previously reported in the literature.

Case report

A 20-year-old previously healthy woman presented with 1 month of intermittent nausea, vomiting, headaches and blurred vision, 1–2 weeks of weakness and paraesthesia in the arms and legs, and pain in the right side of the neck. She was taking no drugs.

Neurological examination showed swollen optic discs. She had bilateral abducens palsies. Shoulder abduction, finger abduction, finger extension and hip flexion were weak bilaterally (Medical Research Council grade 4/5). Muscle stretch reflexes were diffusely absent. Sensation was intact to all modalities. Her gait was slightly unsteady.

Computed tomogram, magnetic resonance angiogram, magnetic resonance venogram and magnetic resonance image of the brain with contrast, and magnetic resonance image of the cervical and lumbar spine with contrast were normal. The following laboratory studies were unremarkable: pregnancy test, electrolytes, complete blood count, liver enzymes, urine analysis, prothrombin time or partial thromboplastin time, antinuclear antibodes and HIV. Erythrocyte sedimentation rate was increased at 60. Lumbar puncture showed an opening pressure of 550 mm H₂O. Analysis of the cerebrospinal …