Transient oculomotor nerve palsy associated with spontaneous intracranial hypotension in a pediatric patient

Spontaneous intracranial hypotension (SIH) is a condition where cerebrospinal fluid (CSF) levels decrease and is primarily caused by spontaneous CSF leaks, most commonly occurring at the level of the thoracic spine. We report the first case of a transient and isolated oculomotor nerve (cranial nerve III) palsy associated with SIH and elevated CSF protein in a pediatric patient. Unlike typical SIH cases that often present with decreased CSF protein, this patient's findings emphasize the variability in SIH manifestations and emphasize the necessity for clinical suspicion and accurate diagnosis to avoid serious complications.