Intermittent ataxia is an abnormality in muscle coordination during walking that produces an irregular gait. The study on intermittent ataxia reveals the rare and dynamic behavior of an ependymal cyst. Ependymal cysts are rare, neuro-ectoderm derived, benign lesions; mostly diagnosed incidentally on MRI. The cyst presented antero-superiorly in the third ventricle, colloid cysts (0.5-1% of all brain tumors). In 18 months old girl, reported a case of ependymal cyst, with intermittent ataxia and vomiting. Endoscopic cyst ablation resulted in excellent recovery and complete resolution of symptoms.
Patient used to experience episodic difficulty in walking, intermittent ataxia, broad-based gait and vomiting, over the course of three weeks, other than the suggestive ataxia, neurologic examination including funduscopic examination was unremarkable.
MRI revealed mildly dilated lateral ventricles and an intraventricular cyst 1.7 x 1. 5 x 1.1 cm, located anteriorly in the third ventricle, at the level of Foramen of Monro. Neurosurgical ablation was performed through a right frontal approach followed by endoscopic third ventriculostomy. The acute presentation can be in the form of nausea, vomiting, drop attacks and transient loss of consciousness secondary to acute hydrocephalus.
While third ventricular cysts are very uncommon in infants and children, they should be considered in the differential diagnosis of intermittent symptoms that are suggestive of raised intracranial pressure.