Skip to main content Accessibility help
×
Home
Hostname: page-component-7ccbd9845f-dxj8b Total loading time: 0.617 Render date: 2023-02-01T03:38:00.694Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Neuroepithelial Cysts Presenting with Movement Disorders: Two Cases

Published online by Cambridge University Press:  02 December 2014

Navraj S. Heran
Affiliation:
Surgical Centre for Movement Disorders, Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada
Caglar Berk
Affiliation:
Surgical Centre for Movement Disorders, Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada
Constantine Constantoyannis
Affiliation:
Surgical Centre for Movement Disorders, Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada
Christopher R. Honey
Affiliation:
Surgical Centre for Movement Disorders, Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada
Rights & Permissions[Opens in a new window]

Abstract

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

The authors present two cases of movement disorders caused by neuroepithelial cysts and highlight their management. Neuroepithelial cysts are ependymal or epithelial lined fluid collections of unknown etiology within the central nervous system parenchyma with no obvious ventricular or subarachnoid connection. Most cysts are asymptomatic, however, some present with seizures, mass effect, or rarely with movement disorders.

Case Reports:

The first patient, a 27-year-old female, presented with progressive weakness, dystonic posturing, tremor, ballismus and choreoathetotic movements of her right upper extremity. Her symptoms improved after stereotactic drainage of a neuroepithelial cyst in her basal ganglia but recurred within a year. The second case, a 56-year-old female, presented with diplopia, nystagmus, gait imbalance and hemiparesis. Her symptoms improved after stereotactic drainage of a midbrain neuroepithelial cyst. The cyst reaccumulated over the next few years and she became symptomatic with left arm tremor and facial weakness. Aspiration was again performed with symptomatic improvement for nine months. Her tremor recurred and a cyst access device was placed stereotactically. She improved and has remained stable for over a year.

Conclusion:

Simple stereotactic drainage of neuroepithelial cysts has a high recurrence rate. The authors recommend considering placement of a drainage device to facilitate aspiration of the cyst fluid during follow-up, if needed.

Résumé:

RÉSUMÉ:Introduction:

Les auteurs présentent deux cas de désordres du mouvement causés par des kystes neuroépithéliaux et discutent de leur traitement. Les kystes neuroépithéliaux sont des cavités remplies de liquide, tapissées de cellules épendymales ou épithéliales d'étiologie inconnue dans le parenchyme du système nerveux central, sans connexion ventriculaire ou sous-arachnoïdienne évidente. La plupart des kystes sont asymptomatiques, mais certains patients présentent des crises convulsives, un effet de masse ou rarement un désordre du mouvement.

Observation:

La première patiente, une femme âgée de 27 ans, a consulté pour une faiblesse progressive, une posture dystonique, du tremblement, du ballisme et des mouvements choréoathétosiques du membre supérieur droit. Ses symptômes se sont améliorés après drainage stéréotaxique d'un kyste neuroépithélial situé au niveau des noyaux gris centraux, mais elle a présenté une récidive des symptômes en dedans d'un an. Le deuxième cas, une patiente âgée de 56 ans, a consulté pour diplopie, nystagmus, déséquilibre à la marche et hémiparésie. Ses symptômes se sont améliorés après drainage stéréotaxique d'un kyste neuroépithélial du mésencéphale. Le kyste s'est reformé de nouveau au cours des années et elle a présenté du tremblement du bras gauche et de la faiblesse des muscles faciaux. Une nouvelle aspiration a été effectuée avec amélioration des symptômes pendant neuf mois. Son tremblement a réapparu et un accès au kyste a été implanté par stéréotaxie. Son état s'est amélioré et elle est demeurée stable pendant plus d'un an.

Conclusions:

Le drainage stéréotaxique simple de kystes neuroépithéliaux comporte un taux de récidive élevé. Les auteurs recommendent de considérer la mise en place d'un dispositif de drainage pour faciliter l'aspiration du liquide contenu dans le kyste, au besoin.

Type
Case Report
Copyright
Copyright © The Canadian Journal of Neurological 2003

References

1. Gonzalez, C, Roda, JM, Alvarez, F, et al. Supratentorial neuroepithelial cysts. Report of two cases. J Neurosurg Sci 1984; 28: 97102.Google ScholarPubMed
2. Guermazi, A, Miaux, Y, Majoulet, JF, et al. Imaging findings of central nervous system neuroepithelial cysts. Eur Radiol 1998; 8: 618623.CrossRefGoogle Scholar
3. Lustgarten, L, Papanastassiou, V, McDonald, B, et al. Benign intracerebral cysts with ependymal lining: pathological and radiological features. Br J Neurosurg 1997; 11: 393397.CrossRefGoogle ScholarPubMed
4. Wester, K, Pedersen, PH. Benign intracerebral cysts treated with internal shunts: review and report of two patients. Neurosurgery 1992; 30: 432436.CrossRefGoogle ScholarPubMed
5. Morioka, T, Nishio, S, Suzuki, S, et al. Choroidal fissure cyst in the temporal horn associated with complex partial seizure. Clin Neurol Neurosurg 1994; 96: 164167.CrossRefGoogle ScholarPubMed
6. Tamayo, JA, Ojea, T, Hervas, M, et al. [Neuroepithelial cyst of the choroid sulcus as a probable cause of symptomatic focal epilepsy]. Rev Neurol 1997; 25: 20702071.Google ScholarPubMed
7. Baysefer, A, Erdogan, E, Gezen, F, et al. Cyst of the mesencephalon (neuroepithelial cyst?): review and case report. Minim Invasive Neurosurg 1997; 40: 148150.CrossRefGoogle ScholarPubMed
8. Goh, RH, Maguire, J. Neuroepithelial cyst of the posterior fossa: two case reports with radiologic-pathologic correlation. Can Assoc Radiol J 1996; 47: 126131.Google ScholarPubMed
9. Markwalder, TM, Zimmerman, A. Intracerebral ciliated epithelial cyst. Surg Neurol 1979; 11: 195198.Google ScholarPubMed
10. Bejar, JM, Kepes, J, Koller, WC. Hemiballism and tremor due to ependymal cyst. Mov Disord 1992; 7: 370372.CrossRefGoogle Scholar
11. Friede, RL, Yasargil, MG. Supratentorial intracerebral epithelial (ependymal) cysts: review, case reports, and fine structure. J Neurol Neurosurg Psychiatry 1977; 40: 127137.CrossRefGoogle Scholar
12. Rajshekhar, V. Benign thalamic cyst presenting with contralateral postural tremor. J Neurol Neurosurg Psychiatry 1994; 57: 11391140.CrossRefGoogle ScholarPubMed
13. Tokumitsu, N, Sako, K, Kunimoto, M, et al. Glial cyst in the thalamus with intracystic hemorrhage-case report. Neurol Med Chir (Tokyo)1997; 37: 284287.CrossRefGoogle ScholarPubMed
14. Krauss, J, Grossman, R. Surgery for hyperkinetic movement disorders. In: Jankovic, J, Tolosa, E (Eds): Parkinson's Disease and Movement Disorders. Philadelphia, Pa: Williams & Wilkins, 1998; 10171048.Google ScholarPubMed
15. Krystkowiak, P, Martinat, P, Defebvre, L, et al. Dystonia after striatopallidal and thalamic stroke: clinicoradiological correlations and pathophysiological mechanisms. J Neurol Neurosurg Psychiatry 1998; 65: 703708.CrossRefGoogle ScholarPubMed
16. Shannon, K. Hemiballismus. Clin Neuropharmacol 1990; 13: 413425.CrossRefGoogle ScholarPubMed
17. Nakasu, Y, Handa, J, Watanabe, K. Progressive neurological deficits with benign intracerebral cysts. Report of two cases. J Neurosurg 1986; 65: 706709.CrossRefGoogle Scholar
18. Eiras Ajuria, J, Alberdi Vinas, J. Endoscopic treatment of intracranial lesions. Apropos of 8 cases. Neurochirurgie 1991; 37: 278283.Google Scholar
19. Herrera, EJ, Caceres, M, Viano, JC, et al. Stereotactic neurosurgery in children and adolescents. Childs Nerv Syst 1999; 15: 256261.Google ScholarPubMed
You have Access
21
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Neuroepithelial Cysts Presenting with Movement Disorders: Two Cases
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Neuroepithelial Cysts Presenting with Movement Disorders: Two Cases
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Neuroepithelial Cysts Presenting with Movement Disorders: Two Cases
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *