???Shunt Problem

[Ladyron73]

My son has a vp shunt placed at like 6 weeks old. It has been revised 52 times since. The last one was like a year ago. Well starting like 3 weeks ago he has been having little seizure like episodes where he holds his nose and says it hurts but it just weird it is like he blinks at the same time and makes a really ugly face. He is on topamax for seizures. I took him to the ER on Christmas day and they did a cat scan and said the ct scan looked better then the one he had 7 months ago and that they felt like nothing was wrong with his shunt. He is still having these episodes and I have appointments for a eeg and neurology next week but I am just deathly afraid this is a shunt infection or something. Does this sound like seizures?

[JainMD]

Hi,
How is your son doing? I feel nice that now his seizure episode is less in number. Yes the doctor is right in saying that unless and until you reach correct level of anti-epileptic in brain, the seizures are not going to get controlled.
Yes, if you understand from my previous post that I always wanted to know the reason of seizure. You always said that the doctor does not think that this is due to shunt malfunction and I used to ask then what the reason is.
You are right in thinking that such long time there won't be shunt infection persisting and if it would have been there, then by now it would have been noted.
As there are abnormalities noted on EEG suggests there is background seizure activity.
The cause still remains unknown.
Keep me informed if you have any queries.
Bye.

[Ladyron73]

Ok Brendan is now on Topamax and Lamictal. The Neurologist said the eeg was abnormal...and that was his answer to switch seizure meds. So for now he just added the lamictal. The seizures have seem to be happening a little less, but he still has had a few since being on the lamictal. The neurologist said he may have a few more until we reach the correct does of Lamictal. I just pray everyday it is nothing more...like a shunt infection. I hope by now (like 7 weeks) if it was a shunt infection something would have progressed.

[JainMD]

Hi,
I need to know what the EEG report is.
As your child is being examined by neuro-surgeon and he feels there is no shunt issue means your child is having seizure due to some other etiology.
What is the CSF analysis report?
What medications he is on, can you post it?

[Ladyron73]

I don't get it he isstill having them episodes. I dont understand if it is the shunt...maybe it is infected or something. The nwuro surgeon said it is not a neuro surg issue. I am just so worried.

[Ladyron73]

I don't get it he isstill having them episodes. I dont understand if it is the shunt...maybe it is infected or something. The nwuro surgeon said it is not a neuro surg issue. I am just so worried.

[JainMD]

Hi,
How is he feeling now?
Does he still have seizure?
What is the result of EEG study?
Is there any blood investigations being done?
I think we need to also see his drugs level in body. If prescribed anti-epileptics are decreased in quantity in serum of patients it could lead to seizures.
It is quiet common to increase the dose of anti-epileptics if seizure does not resolve with previously prescribed dose.
Keep me informed.
Bye.

[Ladyron73]

Had several appointments with the neurologist this week and also took Brendan for a EEG....the neurologist feels as through if was his shunt he would have been in failure by now...so he just uped his topamax and said to return in too months...but I am still very worried.

[JainMD]

Hi,
How old is your son?
Did he have seizures before? Does he have any fever now? How are the episodes? Can you describe them?
Do they last long?
Firstly, when a shunt is in place, first diagnosis would be to think about shunt mal-function. To assess shunt functions you would be doing a MRI, which is reported as normal here.
In fact it has mentioned that it has improved from last MRI.
Second, if there is no shunt malfunction then the episodes would be indeed due to seizures.
I think you should be asking neurosurgeon to send for investigations on your son's CSF sample.
I think a consultation with a neurologist is essential.
Keep me informed.
Bye.