Thalamic ependymal cyst presenting with tremor.

CASE REPORT: We report the case of a 6-year-old boy presenting with intention tremor. CT and MR scanning showed a large thalamic cyst. TREATMENT: Stereotactic tapping of this cyst was carried out as the first step in surgical management. Following drainage of the cyst the tremor disappeared, but recurred 18 months later. Repeat MRI showed that the thalamic cyst had refilled. As the initial tapping of the cyst had resulted in effective but only transient clinical improvement a cysto-peritoneal shunting procedure was performed. OUTCOME: The clinical symptoms again disappeared and the child has now remained tremor free for 3 years.