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Neurological rarities
Cerebrospinal fluid shunt-induced chorea: case report and review of the literature on shunt-related movement disorders
  1. Claudio M de Gusmäo1,
  2. Aaron L Berkowitz2,
  3. Albert Y Hung2,
  4. M Brandon Westover2
  1. 1Neurology Department, Boston Children's Hospital, Boston, Massachusetts, USA
  2. 2Neurology Department, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Claudio M de Gusmao, Neurology Department, Boston Children's Hospital, 300 Longwood Ave, Fegan 11, Boston, MA 02115, USA; claudio.degusmao{at}childrens.harvard.edu

https://doi.org/10.1136/practneurol-2014-000913

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    Introduction

    Cerebrospinal fluid (CSF) diversion by shunting provides effective management of hydrocephalus.1 However, complication rates of CSF shunts range from 5% to 50%.1–3 Most common are shunt infections and mechanical failures; these may lead either to underdrainage (with re-emergence of hydrocephalus) or overdrainage (with intracranial hypotension and its potential complications, eg, subdural hematoma).3 ,4 Misplacement and migration of shunt catheters may cause seizures, intracerebral haemorrhage, and/or focal neurologic deficits, such as hemiparesis.1 ,2 We report a case of hemichorea after CSF shunt placement, and review the literature on CSF shunt-related movement disorders.

    Case report

    A 20-year-old woman with congenital hydrocephalus treated by CSF shunting presented with a purulent discharge from the …

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    Footnotes

    • Contributors CMdG: original idea, drafted the manuscript, edited images, performed literature review. ALB: original idea, revised the original manuscript and images, critical appraisal of literature review. AYH and MBW: critical review and modifications of the final manuscript; appraisal of literature review and associated media.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned. Externally peer reviewed. This paper was reviewed by Tony Amato-Watkins, Cardiff, UK.

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    • Editors' commentary
      Highlights from this issue
      Phil Smith Geraint Fuller
      Practical Neurology 2015; 15 1-1 Published Online First: 22 Jan 2015. doi: 10.1136/practneurol-2014-001075