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Movement disorders associated with spontaneous CSF leaks: a case series
1Department of Neurology, Mayo Clinic, Rochester, MN, USA bmokri@mayo.edu.
Cephalalgia : an International Journal of Headache
|April 15, 2014
Summary
Spontaneous cerebrospinal fluid (CSF) leaks can cause movement disorders, though uncommon. Early diagnosis and treatment, including surgery or epidural blood patches, can lead to recovery.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Spontaneous cerebrospinal fluid (CSF) leaks commonly present with headaches.
- Movement disorders are an infrequent but significant manifestation of CSF leaks.
Purpose of the Study:
- To highlight movement disorders as a presenting symptom of spontaneous CSF leaks.
- To describe the clinical characteristics and outcomes of patients with CSF leaks and movement disorders.
Main Methods:
- Clinical evaluation and neuroimaging of five patients (4 women, 1 man) aged 51-78 with spontaneous CSF leaks and movement disorders.
- Follow-up ranged from 1 to 7 years (mean 3.2 years).
Main Results:
- Movement disorders included choreiform movements, torticollis, mixed tremor, and parkinsonism.
- Headaches were present in four patients; neuroimaging showed diffuse pachymeningeal enhancement and brain sinking in all.
- Treatment with epidural blood patches or surgery resulted in partial or complete resolution of symptoms in most patients.
Conclusions:
- Movement disorders, while uncommon, can be a primary clinical feature of spontaneous CSF leaks.
- Timely diagnosis and intervention can lead to significant improvement or recovery.
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