Clinical features

Features include:

• headache tends to be the first symptom - it is worst first thing in the morning and last thing at night, and relieved on standing - consistent with raised intracranial pressure
• gradual visual field defects - due to effects of raised intracranial pressure on cranial nerves
• gross bilateral papilloedema without significant focal intracranial signs
• vomiting, drowsiness

Less commonly:

• diplopia due to VI nerve palsy

In women it may coincide with recent weight gain, fluid retention, the first trimester of pregnancy and the postpartum period.

Reference

1. Blanch RJ et al. Differing presenting features of idiopathic intracranial hypertension in the UK and US. Eye (Lond). 2019 Jun;33(6):1014-9.