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Journal of Child Neurology
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Episodic Brainstem Compression Masquerading as Electrodecremental Seizures

Sylvia Lucas, MD, PhD

Departments of Neurology and Pediatrics, and the Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, New York, NY

Gail Solomon, MD

Departments of Neurology and Pediatrics, and the Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, New York, NY

Douglas Labar, MD, PhD

Departments of Neurology and Pediatrics, and the Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, New York, NY

Abe Chutorian, MD

Departments of Neurology and Pediatrics, and the Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, New York, NY

An 8-year-old boy developed generalized tonic spasms lasting minutes accompanied by an electrodecremental event on electroencephalogram in association with increased intracranial pressure caused by shunt malfunction. The electroencephalographic abnormalities and clinical attacks occurred despite an otherwise normal neurologic examination, normal initial opening pressure on lumbar puncture and shunt tap, and only mild ventricular dilation revealed by brain imaging. There was no improvement with antiepileptic drugs. Further signs of uncal herniation led to repeat tap of the shunt, revealing a pressure of 800 mm of water. After revision of the shunt "seizures" stopped and the electroencephalogram returned to normal. Antiepileptic drugs were discontinued, with no recurrence of events. (J Child Neurol 1994;9:167-169).

Journal of Child Neurology, Vol. 9, No. 2, 167-169 (1994)
DOI: 10.1177/088307389400900212
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