Reversible parkinsonism following ventriculoperitoneal shunt in a patient with obstructive hydrocephalus secondary to intraventricular neurocysticercosis

Parkinsonism with evidence of midbrain dysfunction has been reported in a few patients with aqueductal stenosis after placement of ventriculoperitoneal (VP) shunt. The response to levodopa is variable. We report a patient with neurocysticercosis of the fourth ventricle who developed transient parkinsonism without evidence of midbrain dysfunction after placement of a VP shunt. The frequency of tremor was 5–5.5 Hz. Though the response to levodopa was initially slow, later it was significant, and after 3 months he was asymptomatic without levodopa. The exact pathophysiology of parkinsonism in our patient remained obscure.