Abstract

A 19-year-old male presented with bilateral facial nerve palsy characteristic of Moebius syndrome, which is known for congenital facial and abducens nerve involvement. However, this case exhibited an unusual association with Idiopathic Intracranial Hypertension(IIH), a condition characterized by elevated intracranial pressure. Ocular examination revealed bilateral sixth and seventh nerve paralysis with papilledema. The patient experienced symptoms of headache and transient vision obscuration, leading to extensive diagnostic evaluation. MRI brain with orbit with MRV with contrast study revealed empty sella syndrome, suggesting IIH which was supported with elevated Lumbar puncture opening pressure (28 mm Hg) . Medical management with carbonic anhydrase inhibitors was initiated. Further, the patient was referred to neurosurgeon for CSF diversion procedure (Ventriculoperitoneal Shunt). This case highlights the importance of thorough patient assessments in similar clinical scenarios.