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

  • Michal Gafner
  • Tally Lerman-Sagie
  • Shlomi Constantini
  • Jonathan RothEmail author
Case Report


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.


Hydrocephalus Refractory epilepsy Ventriculoperitoneal shunt Over-drainage Endoscopic third ventriculostomy 


Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael
  2. 2.Pediatric Neurology UnitWolfson Medical CenterHolonIsrael
  3. 3.Department of Pediatric NeurosurgeryDana Children’s Hospital, Tel Aviv Medical CenterTel AvivIsrael

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