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Refractory epilepsy associated with ventriculoperitoneal shunt over-drainage: case report

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Abstract

Epilepsy and intracranial pressure (ICP) can be interrelated. While shunt malfunction is recognized as a cause of seizures, shunt over-drainage is seldom reported as such. We report a child who had undergone ventriculoperitoneal shunt insertion at the age of 6 months following an excision of a left ventricle choroid plexus papilloma, who developed refractory epilepsy since the age of 3 years. An MRI showed small ventricles. The child presented with acute hydrocephalus due to proximal shunt malfunction at the age of 11 years and was treated with an endoscopic third ventriculostomy. Following the procedure, the seizures abated. Our case suggests that intractable epilepsy may be related to intracranial hypotension. Potential treatments for shunt over-drainage may be indicated even in the absence of classic over-drainage symptoms, in the presence of refractory epilepsy.

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Authors and Affiliations

  1. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Michal Gafner, Tally Lerman-Sagie, Shlomi Constantini & Jonathan Roth

  2. Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel

    Tally Lerman-Sagie

  3. Department of Pediatric Neurosurgery, Dana Children’s Hospital, Tel Aviv Medical Center, 6 Weizman Street, 64239, Tel Aviv, Israel

    Shlomi Constantini & Jonathan Roth

Authors
  1. Michal Gafner
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  2. Tally Lerman-Sagie
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  3. Shlomi Constantini
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  4. Jonathan Roth
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Correspondence to Jonathan Roth.

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Gafner, M., Lerman-Sagie, T., Constantini, S. et al. Refractory epilepsy associated with ventriculoperitoneal shunt over-drainage: case report. Childs Nerv Syst 35, 2411–2416 (2019). https://doi.org/10.1007/s00381-019-04367-x

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  • DOI: https://doi.org/10.1007/s00381-019-04367-x

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