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Reversible parkinsonism due to a large intracranial tumour
  1. Helena Rocha1,2,
  2. António Cerejo2,3,
  3. Maria Carolina Garrett2,4,
  4. João Massano2,4
  1. 1Department of Neurology, Centro Hospitalar de São João, Oporto, Portugal
  2. 2Department of Clinical Neuroscience and Mental Health, Faculty of Medicine University of Porto, Porto, Portugal
  3. 3Department of Neurosurgery, Centro Hospitalar de São João, Oporto, Portugal
  4. 4Movement Disorders and Functional Surgery Unit, and Department of Neurology, Centro Hospitalar de São João, Oporto, Portugal
  1. Correspondence to Professor Maria Carolina Garrett, garrett.mc51{at}gmail.com

Summary

A 77-year-old woman presented with progressively worsening apathy, depression, urinary incontinence and slowness of movement for the past 1 year. Asymmetric akinetic-rigid parkinsonism and mild left-sided hyper-reflexia were seen on examination. No ocular movement impairment, cerebellar or sensory signs were noticed. Routine laboratory testing was normal. Brain imaging revealed a large frontal tumour which was subsequently excised and pathologically confirmed as a meningioma. Marked clinical improvement was documented 3 months after surgery, and persistent clinical and imaging remission have been confirmed annually for the following 3 years. There have been some reports of parkinsonism associated with intracranial tumours. Although this is probably an uncommon situation, it is potentially treatable, and symptoms might even remit completely following successful management. Parkinson's disease is a common cause of parkinsonism, but alternative aetiologies should be suspected whenever atypical findings are demonstrated by clinical history or examination.

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