Intractable seizures associated with proximal migration of a ventriculoperitoneal shunt. Case report.
A 6-year-old girl, who had received a ventriculoperitoneal (VP) shunt using the Codman-Hakim programmable valve system at age 3 months, presented with intractable seizures. Neuroimaging studies showed migration of the proximal part of the system, including the prechamber, into the cranium through the right frontal burr hole. Electroencephalography showed spike-and-wave complexes in the right hemisphere including the site of the migration. The ictus was resolved following revision surgery. The clinical findings suggested the seizures were due to irritation of the brain parenchyma by the migrated system. Proximal migration of a VP shunt may cause both shunt failure and additional focal symptoms.
Yamazaki
Tomoya
T
Department of Neurosurgery, Kitasato University School of Medicine, Kanagawa, Japan.
Shimizu
Satoru
S
Sagiuchi
Takao
T
Iwasaki
Toshiyuki
T
Utsuki
Satoshi
S
Suzuki
Sachio
S
Fujii
Kiyotaka
K
D005260:Female; D005548:Foreign-Body Migration / Q000150:complications*; D006801:Humans; D007223:Infant; D012640:Seizures / Q000209:etiology*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*