Article

Parkinsonism as an initial manifestation of brain tumor

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Abstract

Parkinsonism secondary to neoplasm is uncommon. We report two patients with bilaterally symmetric parkinsonism as the initial presentation of their brain tumors. The first patient was a 71-year-old woman who presented with a gradual onset of bilateral resting tremor, bradykinesia and rigidity. Computerized tomography (CT) of the brain revealed a large parasagittal tumor in the left frontal lobe. The patient completely recovered from the parkinsonian symptoms after removal of the brain tumor. The second patient, a 74-year-old man with a history of renal cell carcinoma of the right kidney suffered from an insidious onset of bilateral bradykinesia, rigidity and gait difficulty. Cerebral metastasis was noted on the brain CT scan. Early recognition of intracranial tumor as the cause of parkinsonism is important for the management of this type of movement disorder. Moreover, brain CT scanning plays an important role in the differential diagnosis of patients with parkinsonian symptoms.

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... Parkinsonism caused by brain tumor is uncommon. [3][4][5][6][7] Brain tumors showing Parkinsonism were various such as astrocytoma, meningiomas, craniopharyngiomas, and metastasis. They were usually supratentorial lesions involving the basal ganglia or the nigrostriatal tract, directly or indirectly. ...
... Brain metastases occur in only 4% of cases, however, and are usually present with hemiparesis or other motor or sensory symptoms. There have been very few reports of parkinsonism secondary to a brain tumor [2] or other brain lesion with a mass effect [3] . Supratentorial lesions involving the caudate-putamen or the striatonigral tract are the most common lesions described in these reports, but occasionally no lesion is identified. ...
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