title: Oculogyric crisis masquerading as ventriculoperitoneal shunt dysfunction.
abstract: Oculogyric crisis (OGC) is an underrecognized oculodystonic reaction associated with several medications including carbamazepine. The authors present a patient who had presented to the emergency department on multiple occasions with a questionable ventriculoperitoneal (VP) shunt dysfunction. Symptoms included nausea, vomiting, altered level of consciousness, ataxia, and vertical eye deviation. The patient underwent multiple revisions of the VP shunt with transient and questionable improvement. During her visit to the neurology clinic, OGC from carbamazepine was suspected, and the dose was reduced. The patient has been completely asymptomatic for the past 18 months. The authors report this case to increase the awareness of carbamazepine-induced OGC as one of the differential diagnoses for VP shunt dysfunction.
authors.affiliation: Division of Neurology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Nail H
authors.initials: NH
authors.lastname: AlAzwary
authors.forename: Taim
authors.initials: T
authors.lastname: Muayqil
authors.forename: Zaeem A
authors.initials: ZA
authors.lastname: Siddiqi
authors.forename: S Nizam
authors.initials: SN
authors.lastname: Ahmed
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004421:Dystonia / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology / Q000601:surgery*; D009801:Oculomotor Muscles / Q000503:physiopathology*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine