title: Magnetic toys: forbidden for pediatric patients with certain programmable shunt valves?
abstract: BACKGROUND
  Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the potential effects of magnetic toys on programmable valves are not well known.
  
  
  METHODS
  The magnetic properties of nine toy magnets were examined. To calculate the effect of a single magnet over a distance, the magnetic flux density was directly measured using a calibrated Hall probe at seven different positions between 0 and 120 mm from the magnet. Strata II small (Medtronic Inc.), Codman Hakim (Codman & Shurtleff), and Polaris (Sophysa) programmable valves were then tested to determine the effects of the toy magnets on each valve type.
  
  
  RESULTS
  The maximal flux density of different magnetic toys differed between 17 and 540 mT, inversely proportional to the distance between toy and measurement instrument. Alterations to Strata and Codman valve settings could be effected with all the magnetic toys. The distances that still led to an alteration of the valve settings differed from 10 to 50 mm (Strata), compared with 5 to 30 mm (Codman). Valve settings of Polaris could not be altered by any toy at any distance due to its architecture with two magnets adjusted in opposite directions.
  
  
  CONCLUSIONS
  This is the first report describing changes in the pressure setting of some adjustable valves caused by magnetic toys in close contact. Parents, surgeons, neurologists, pediatric oncologists, and paramedics should be informed about the potential dangers of magnetic toys to prevent unwanted changes to pressure settings.
authors.affiliation: Division of Oncology, University Children's Hospital of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
authors.forename: Tycho J
authors.initials: TJ
authors.lastname: Zuzak
authors.forename: Bettina
authors.initials: B
authors.lastname: Balmer
authors.forename: Daniel
authors.initials: D
authors.lastname: Schmidig
authors.forename: Eugen
authors.initials: E
authors.lastname: Boltshauser
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grotzer
mesh_terms: D002675:Child, Preschool; D004574:Electromagnetic Fields / Q000009:adverse effects*; D006801:Humans; D008280:Magnetics / Q000295:instrumentation* / Q000706:statistics & numerical data; D010988:Play and Playthings; D011475:Prosthesis Failure; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*