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Slit ventricle syndrome presenting with paroxysmal hypersomnia in an adult: case report
1Department of Neurosurgery, Uludag University School of Medicine, Bursa, Turkey.
Insights
Slit ventricle syndrome (SVS), a rare shunt malfunction causing increased intracranial pressure, can manifest in adults. This case highlights SVS presenting as prolonged hypersomnia in a 29-year-old woman, resolving after catheter revision.
Area of Science:
- Neurosurgery
- Neurology
- Pediatric hydrocephalus management
Background:
- Slit ventricle syndrome (SVS) is typically seen in children with shunted hydrocephalus.
- It involves intermittent shunt malfunction without significant ventricular enlargement, often due to catheter obstruction.
- SVS in adults is exceptionally rare.
Observation:
- A 29-year-old woman presented with recurrent, prolonged episodes of hypersomnia.
- Computed tomography revealed small lateral ventricles, suggestive of SVS.
- Her hypersomnia occurred every 2-3 weeks, lasting 1-2 weeks per episode.
Findings:
- The patient's symptoms were attributed to shunt malfunction consistent with SVS.
- Revision of the ventricular catheter successfully resolved the hypersomnia.
- This suggests SVS can present atypically in adults.
Implications:
- Adult-onset SVS should be considered in the differential diagnosis of unexplained hypersomnia.
- Prompt diagnosis and intervention, such as shunt revision, can lead to complete symptom resolution.
- This case expands the known clinical spectrum of SVS beyond pediatric populations.
Abstract:
The slit ventricle syndrome (SVS), defined as intermittent shunt malfunction without substantial ventricular enlargement, is usually observed in shunted children with small, slitlike ventricles. This syndrome has been attributed to recurrent obstruction of the ventricular catheter, which then causes an increase of intracranial pressure. Only rarely has the SVS been reported in adults. We describe a 29-year-old woman whose shunt malfunction presented with long-lasting paroxysmal hypersomnia and was diagnosed with computed tomographic evidence of small lateral ventricles. This episodic hypersomnia presented every 2 to 3 weeks and each episode lasted 1 to 2 weeks. After revision of the ventricular catheter, her symptoms stopped and she remained well.