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Year : 2000  |  Volume : 48  |  Issue : 2  |  Page : 190-1

An unusual case of Parkinsonism secondary to right parasagittal meningioma.






How to cite this article:
Saleem S M, Shah S, Kirmani A, Dhobi G N. An unusual case of Parkinsonism secondary to right parasagittal meningioma. Neurol India 2000;48:190


How to cite this URL:
Saleem S M, Shah S, Kirmani A, Dhobi G N. An unusual case of Parkinsonism secondary to right parasagittal meningioma. Neurol India [serial online] 2000 [cited 2020 Dec 1];48:190. Available from: https://www.neurologyindia.com/text.asp?2000/48/2/190/1543



Parkinsonism is a progressive disease of nervous system. In over 85 percent of cases, the cause is unknown. Intracranial space occupying lesion (ICSOL) is one of the curable causes of parkinsonism. Various sites of ICSOL givng rise to parkinsonism described in the literature include frontal lobe, temporal lobe, parietal lobe, septum pellucidum, brainstem, parasagittal region, supraseller and sphenoidal wing regions. Early suspicion of these cases is of prime importance as they are amenable to definitive treatment. We describe an unusual case of right parasagittal meningioma presenting as parkinsonism, in whom symptoms got completely relieved after surgery.
A 48 year male presented with slowness of activities of daily living and slowly progressive resting tremor of left hand of six months duration. There was no history suggestive of raised intracranial pressure, meningitis, trauma, drug intake or family history of such illness. He was normotensive and had masked facies, resting tremor in left hand, slowness in communication and bradykinesia. Higher mental functions were normal. There was rigidity in upper and lower limbs. All superficial and deep tendon reflexes were normal. Left plantar was extensor. Glabellar tap and left palmar grasp were positive. There was no papilloedema. All biochemical investigations were normal. In view of asymmetry of symptoms and signs, a CT scan of brain was done which revealed a well circumscribed homogenous, right parasagittal mass without ventricular dilatation or midline shift [Figure. 1]. He was operated upon and a histopathological diagnosis of meningothelial meningioma was made. The patient, on follow up, showed complete recovery in his extrapyrimidal symptoms and signs. Parkinsonism is rarely caused by brain tumours. It is established that these tumours may compress or infiltrate the basal nuclei or brain stem. Kaijima et al[1] reviewed 58 cases of parkinsonism associated with intracranial space occupying lesions, out of which 8 were infiltrating gliomas involving thalamus, basal ganglia or midbrain. Four supratentorial tumour sites are described in literature i.e. frontal, temporal, parietal and thalamus.[2] Nearly all symptoms are possibly produced by compression of basal ganglia. All cases of parkinsonism, with unilateral symptoms and signs and profound dementia should have CT or MRI to rule out treatable cause.

 

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1.Kaijima M et al: Epidermoid in the middle cranial fossa presenting with hemiparkinsonism: A case report. No Shinkei Geka 1978; 6: 1103-1108.   Back to cited text no. 1    
2.Polyzoidis KS et al: Parkinsonism as a manifestation of brain tumour. Surg Neurol 1985; 23: 59-63.   Back to cited text no. 2    

 

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Online since 20th March '04
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