Involuntary movements of ...

A 8-year-old child came to hospital with the chief complaints of involuntary movements of head as excessive head nodding since 1 year, gradual in onset, progressive in nature. Patient is able to control head movements voluntarily. Movements are increased with emotions and stress, decreased during sleep. No other positive significant history.

Examination

Clinical examination shows patient is conscious and coherent and fundus examination showed temporal pallor, more on the right side. The remainder of the nervous system examination was normal. CT and MRI of the brain was done, which shows a cystic lesion arising from suprasellar region extending upwards causing compression of the third ventricle leading to obstructive hydrocephalous at the level of the third ventricle. The cystic fluid shows signal intensity equal to the cerebrospinal fluid (CSF) intensity in all sequences in MRI suggestive of giant suprasellar arachnoid cyst causing involuntary head movements