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Related Experiment Videos

Episodic brainstem compression masquerading as electrodecremental seizures

S Lucas1, G Solomon, D Labar

  • 1Department of Neurology, New York Hospital-Cornell Medical Center, NY 10021.

Journal of Child Neurology
|April 1, 1994
PubMed
Summary

A shunt malfunction caused increased intracranial pressure, leading to seizures and electroencephalogram abnormalities in a child. Shunt revision resolved the seizures and normalized electroencephalogram findings, demonstrating the critical role of shunt function.

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Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Hydrocephalus management often involves cerebrospinal fluid (CSF) shunts.
  • Shunt malfunction can lead to increased intracranial pressure (ICP).
  • Elevated ICP can manifest with diverse neurological symptoms, including seizures.

Observation:

  • An 8-year-old boy presented with generalized tonic spasms and electroencephalogram (EEG) abnormalities.
  • Initial evaluations, including lumbar puncture and shunt tap, showed normal pressures, and imaging revealed only mild ventricular dilation.
  • Clinical attacks and EEG abnormalities persisted despite antiepileptic drug (AED) treatment.

Findings:

  • Recurrent shunt malfunction was diagnosed, with a repeat shunt tap revealing significantly elevated ICP (800 mm H2O).

Related Experiment Videos

  • Shunt revision successfully corrected the malfunction.
  • Following shunt revision, the patient's clinical seizures ceased, and EEG recordings normalized.

    • Implications:

    • This case highlights the importance of considering shunt malfunction in pediatric patients with unexplained seizures, even with initially normal pressure readings.
    • Prompt diagnosis and surgical intervention (shunt revision) are crucial for managing shunt-related complications and preventing neurological damage.
    • Normalizing ICP through shunt revision can effectively resolve refractory seizures and EEG abnormalities, obviating the need for long-term antiepileptic drug therapy.