Peripheral facial nerve palsy following ventriculoperitoneal shunting in an infant

Golpayegani, Mehdi; Habibi, Zohreh; Anari, Mahtab Rabbani; Nejat, Farideh

doi:10.1007/s00381-019-04295-w

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Sometimes cranial nerve damage can occur during surgery like our previous case of an infant who suffered peripheral facial nerve palsy following VP shunting. We found that the underdeveloped bony structures may have rendered the extracranial part of the facial nerve more vulnerable to blunt trauma [35]. In another study, Kumaria et al reported a case of 7th palsy following VP shunting.…”

Section: Discussionmentioning

confidence: 65%

Odd presentation of shunt malfunction: a case series and review of literature

et al. 2023

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Children with previous ventriculoperitoneal shunt (VPS) insertion may refer to the hospital with various clinical complaints. Shunt malfunction is frequently diagnosed in these children necessitating shunt revision. Although increased head circumference, setting sun eye in younger children and headache, nausea/ vomiting, loss of consciousness, visual disturbance, and so on are common clinical manifestations of shunt malfunction, some patients may present with odd or unusual presentation. Here, we present a series of patients with previous shunt insertions who presented with odd and unexpected clinical manifestations. MethodsEight children with shunt malfunction were enrolled in this series. The age, sex, age of shunting, etiology of hydrocephalus and management, post-shunt insertion symptoms/sign, revision surgery, outcome and follow-up were evaluated. ResultsPatients were aged from 1 to 13 years (mean, 6.38 years). There were 5 males and 3 females. The odd presentation associated with shunt malfunction included facial palsy in three children, ptosis in 3 children, and torticollis and dystonia in 2 children. All patients underwent shunt revision except for one patient in whom a new shunt was inserted. Follow-up showed improved clinical presentation in all patients. ConclusionIn this series, we reported eight patients with unusual signs and symptoms following shunt malfunction that were successfully diagnosed and managed.

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Section: Discussionmentioning

confidence: 65%

Odd presentation of shunt malfunction: a case series and review of literature

et al. 2023

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“…Although occurrence of cranial nerve palsies is uncommon, it is reported in youngsters. 15 Low motor neuron facial nerve palsies have only rarely been reported to arise after VPS in three individuals 16 17 18 and one after an isolated fourth ventricular shunt. 19 In two cases, both facial and abducens nerve palsies were caused by VPS implantation.…”

Section: Discussionmentioning

confidence: 99%

Systemic Review: Neurological Deficits following Ventriculoperitoneal Shunt (VPS) Insertion

Moshref,

Algethmi

2023

Asian J Neurosurg

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A reduction in fluid absorption or an obstruction of normal outflow is a common cause of hydrocephalus. It typically requires medical attention, which frequently entails the placement of a ventriculoperitoneal shunt (VPS) to lower intracranial pressure. We intend to list the few, documented examples of neurological impairments resulting from the installation of a VPS in this systematic study. Two search engines (PubMed and Cochrane) were used to conduct a systematic review from 1975 to December 12, 2021. The following search terms were employed: neurological deficits or neurological injury or palsies or thalamus or tract or longitudinal fasciculus or somatotropy or fasciculus or hearing loss or hemisensory or cortico AND ventriculoperitoneal shunt or VPS AND hydrocephalus. The inclusion criteria included VPS, neurological deficits, and human participants. The exclusion criteria included ventriculoarterial shunt, lumboperitoneal shunt, nonhuman subjects, and infection. Twenty trials in total, including a total of 25 patients, were included. There were 17 case report studies. A total of 35/785 patients (4.46%) experienced neurological impairments. In 9/25 (36%) of shunt cases had one of the three recognized causes: trapped fourth ventricle, dandy walker, or syringomyelia. Most of the patients developed VI, VII nerve palsies 11/25 (44%) followed by weakness, cerebellar symptoms, and VI nerve palsy. The brainstem was seen to be the most often injured structure (15/25; 60%), followed by deep brain structures (thalamus, basal ganglia, and white matter tracts; 20%). Even though ventriculoperitoneal shunting is a routine and straightforward treatment, issues can still arise. Although rare, there have been reports of cranial nerve impairments, therefore care should be taken.

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Experience With Ventriculoperitoneal and Lumboperitoneal Shunting for the Treatment of Idiopathic Intracranial Hypertension: A Single Institution Series

et al. 2021

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BACKGROUND CSF shunting is among the most widely utilized interventions in patients with idiopathic intracranial hypertension (IIH). Ventriculoperitoneal shunting (VPS) and lumboperitoneal shunting (LPS) are 2 possible treatment modalities. OBJECTIVE To evaluate and compare complications, malfunction, infection, and revision rates associated with VPS compared to LPS. METHODS Electronic medical records were reviewed to identify baseline and treatment characteristics for patients diagnosed with IIH treated with VPS or LPS. RESULTS A total of 163 patients treated with either VPS (74.2%) or LPS (25.8%) were identified. The mean follow-up was 35 mo. Shunt revision was required in 40.9% of patients. There was a nonsignificant higher rate of revision with LPS (52.4%) than VPS (36.4%, P = .07). In multivariate analysis, increasing patient age was associated with higher odds of shunt revision (P = .04). LPS had higher odds of shunt revision, yet this association was not significant (P = .06). Shunt malfunction was the main indication for revision occurring in 32.7%, with a significantly higher rate with LPS than VPS (P = .03). In total, 15 patients had shunt infection (9.4% VPS vs 12.2% LPS P = .50). The only significant predictor of procedural infection was the increasing number of revisions (P = .02). CONCLUSION The incidence of shunt revision was 40.9%, with increasing patient age as the sole predictor of shunt revision. The incidence of shunt malfunction was significantly higher in patients undergoing LPS, while there was no significant difference in the incidence of shunt infection between the 2 modalities.

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Peripheral facial nerve palsy following ventriculoperitoneal shunting in an infant

Cited by 4 publications

References 11 publications

Odd presentation of shunt malfunction: a case series and review of literature

Odd presentation of shunt malfunction: a case series and review of literature

Systemic Review: Neurological Deficits following Ventriculoperitoneal Shunt (VPS) Insertion

Experience With Ventriculoperitoneal and Lumboperitoneal Shunting for the Treatment of Idiopathic Intracranial Hypertension: A Single Institution Series

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