Multiple Sclerosis Presenting as Intracranial Hypertension in the Setting of COVID-19 Infection

Abstract

Mustafa Hammad and Mohammad Abo Ghosh

Background: Multiple sclerosis (MS) and idiopathic intracranial hypertension (IIH) occur more commonly in women of childbearing age. There are altered cerebrospinal fluid dynamics in both diseases, causing them to have similar presentations at times. Coronavirus disease 19 (COVID-19) has also been reported to affect the central nervous system (CNS) of any age.

Case Presentation: We report a19 year old male who initially presented with headaches and fever, and was diagnosed with COVID-19 infection. A few days later, he developed acute severe left eye pain, blurred vision, diplopia, and left ear tinnitus. The patient was found to have reduced visual acuity, left sixth nerve palsy, esotropia and asymmetric bilateral papilledema. Later, he developed left facial nerve palsy. MRI of the brain showed extensive demyelinating lesions. Lum- bar puncture revealed significantly increased intracranial pressure (ICP) and positive oligoclonal bands.

Conclusion: This is a unique case of MS presenting with intracranial hypertension (IH) in the setting of COVID-19 infection that could have been the trigger for the MS clinical attack.

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