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Complications associated with intrathecal drug delivery in a paediatric patient with Niemann-Pick type C
  1. Jose Ignacio Rodriguez Rodriguez Ciancio1 and
  2. Kristian Aquilina2
  1. 1Metabolic Medicine, Great Ormond Street Hospital for Children, London, UK
  2. 2Neurosurgery, Great Ormond Street Hospital for Children, London, UK
  1. Correspondence to Dr Jose Ignacio Rodriguez Rodriguez Ciancio; sejjjci{at}ucl.ac.uk

Abstract

We report on a male subject with a diagnosis of Niemann-Pick type C (NPC). He received an experimental medicinal product intrathecally initially via lumbar puncture (LP) and eventually via intrathecal drug delivery device. Shortly after implantation, the device catheter migrated outside of the intrathecal space and coiled subcutaneously. The treatment continued via LP after removal of the device. A subdural haematoma developed after repeated LPs. It was surgically evacuated and the patient recovered with sequelae. Surgically implanted drug delivery devices are designed to bypass the blood–brain barrier and deliver a medicinal product directly into the cerebrospinal fluid circulation. Their use has extended into the field of neurodegenerative disorders. Significant adverse events can occur at any given time after implantation including neurological injury, dislodgement or displacement of any of its components, infection and drug-related complications; all can significantly affect the quality of life of patients. Repeated LPs also carry significant risk.

  • paediatrics (drugs and medicines)
  • neurological injury
  • spinal cord
  • neurosurgery
  • paediatric surgery

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Footnotes

  • Contributors Dr JIRC: Planning, conduct and reporting of the work described in the article. Dr KA: Contributed with details of surgical procedures. Critical revision for intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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