title: Aqueductal stenosis presenting as isolated tremor: case report and review of the literature.
abstract: Essential tremor is rare in children, particularly in the absence of a significant family history. We report the case of a child with compensated hydrocephalus secondary to aqueductal stenosis whose sole presenting symptom was tremor. An otherwise healthy 6-year-old male developed a fine hand tremor, which over the course of 4 years both increased in intensity and spread to involve the lower limbs and head. After an MRI had confirmed hydrocephalus due to aqueductal stenosis, the patient underwent an endoscopic third ventriculostomy. His tremor improved markedly, but did not completely resolve. Occult hydrocephalus should be considered in the differential diagnosis of new-onset tremor. Progression of the tremor should halt with treatment of the hydrocephalus, and clinical improvement may be seen.
authors.affiliation: Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI 53226, USA. fseiler@mcw.edu
authors.forename: F Arran
authors.initials: FA
authors.lastname: Seiler
authors.forename: Sean M
authors.initials: SM
authors.lastname: Lew
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D014202:Tremor / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*