Refractory epilepsy associated with ventriculoperitoneal shunt over-drainage: case report

Michal Gafner, Tally Lerman-Sagie, Shlomi Constantini, Jonathan Roth*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Epilepsy and intracranial pressure (ICP) can be interrelated. While shunt malfunction is recognized as a cause of seizures, shunt over-drainage is seldom reported as such. We report a child who had undergone ventriculoperitoneal shunt insertion at the age of 6 months following an excision of a left ventricle choroid plexus papilloma, who developed refractory epilepsy since the age of 3 years. An MRI showed small ventricles. The child presented with acute hydrocephalus due to proximal shunt malfunction at the age of 11 years and was treated with an endoscopic third ventriculostomy. Following the procedure, the seizures abated. Our case suggests that intractable epilepsy may be related to intracranial hypotension. Potential treatments for shunt over-drainage may be indicated even in the absence of classic over-drainage symptoms, in the presence of refractory epilepsy.

Original languageEnglish
Pages (from-to)2411-2416
Number of pages6
JournalChild's Nervous System
Issue number12
StatePublished - 1 Dec 2019


  • Endoscopic third ventriculostomy
  • Hydrocephalus
  • Over-drainage
  • Refractory epilepsy
  • Ventriculoperitoneal shunt


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