ADJUSTABLE SHUNT VALVE REPROGRAMMING AT HOME

Abstract

Abstract OBJECTIVE Shunt valve resistance changes using a specialized magnetic programming device permit noninvasive changes to cerebrospinal fluid drainage. In selected cases between 2001 and 2005, patients and families used shunt valve programming devices at home. This study examines the safety and efficacy of this practice. METHODS We conducted a retrospective review of the medical records of patients who had been given a shunt valve-programming device for home use. A survey was mailed to patients or family members requesting information regarding their experiences with the shunt valve programming device. Patient and family responses were tabulated and a statistical analysis was performed. RESULTS Twenty patients or families returned the survey. The median patient age was 19.6 years (range, 6–48 yr); 25% were male. Seventeen patients had pseudotumor cerebri, one had an arachnoid cyst, and two had slit ventricle syndrome. Fifteen patients had lumboperitoneal shunts, one had a ventriculoperitoneal shunt, three had cisterna magna shunts, and one had an arachnoid cyst-to-peritoneal shunt. No adverse events were attributable to the use of the home shunt valve programmer. Thirty-five percent of respondents used the programmer at least once every week, 40% used the programmer between once a week and once a month, and 25% used the programmer less frequently than once per month. Overall, 85% of respondents reported that they benefited “very much” from the use of a home shunt valve programmer and 15% of respondents benefited “somewhat.” CONCLUSION Providing shunt valve programming devices to selected patients for home use is a safe practice associated with high patient satisfaction. However, the selection of appropriate patients, comprehensive patient education, and close patient-physician communication are crucial to the success of this practice.