Parkinsonism after ventriculoperitoneal shunt for hydrocephalus

BMC Neurology

Case Report

Bi W. Chen¹  Wei Mao¹  Yue Zhang¹  Feng Y. Wu¹  Yan Zhang² 

[1] Department of Neurology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China;Department of Neurology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China;Institute Of Sleep And Consciousness Disorders, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, 100053, Beijing, China;

关键词: Parkinsonism;    Ventriculoperitoneal shunt;    Hydrocephalus;    Complication;    Case report;   

DOI  :  10.1186/s12883-023-03064-2

 received in 2022-08-08, accepted in 2023-01-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundParkinsonism after ventriculoperitoneal shunt in patients with hydrocephalus is a rare and profound complication that is often misdiagnosed, causing treatment to be delayed. To date, the characteristics of this disease have not been well described and summarized. Here, we report a rare case of parkinsonism after ventriculoperitoneal shunt; symptoms were aggravated by antipsychotic drugs but showed a good response to Madopar. Such cases have rarely been reported previously.Case presentationA 44-year-old man presented with parkinsonism, bilateral pyramidal tract signs, and oculomotor impairment four years after a successful ventriculoperitoneal shunt for idiopathic aqueduct stenosis resulting in obstructive hydrocephalus. Brain magnetic resonance imaging and computed tomography showed fluctuations in the lateral ventricle and the third ventricle without any intervention. The patient’s condition was aggravated by antipsychotic drugs but showed a good response to Madopar.ConclusionThis observation suggests that parkinsonism in this patient was caused by reversible dysfunction of the presynaptic nigrostriatal dopaminergic pathway due to fluctuations in the lateral ventricle, representing the first hit to the dopaminergic signalling pathway, and antipsychotic drugs had an antagonistic effect on dopamine D2 receptors, representing the second hit. In addition, we summarize the pathophysiological mechanisms, clinical manifestations, treatments, and prognoses of this complication in 38 patients who met the inclusion criteria in 24 previous studies to increase neurologists’ understanding of the disease.

【 授权许可】

CC BY   
© The Author(s) 2023

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