REVIEW

Unusual Case of Parkinsonian Syndrome Induced by a Parasagittal Meningioma: a systematic review

Caso Incomum de Síndrome Parkinsoniana Induzida por Meningioma Parasagital: revisão sistemática

  • Fernanda Lopes Rocha Cobucci (1)
  • Joana Ferro Machado de Almeida (1)
  • Melissa Esposito Gomes Rigueiral (1)
  • Raphael Vinícius Vieira Gonzaga (2)
  • Roger Thomaz Rotta Medeiros (2)
  • Paulo Roberto Franceschini (3)
  • Paulo Henrique Pires de Aguiar (2)(4)
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  Downloads: 50

Resumo

Introdução: A doença de Parkinson é a principal causa primária da síndrome parkinsoniana; caso contrário, outras etiologias devem ser investigadas quando os sintomas aparecem. O parkinsonismo secundário pode ser causado por intoxicações, distúrbios cerebrovasculares e metabólicos, traumatismo craniano, infecções e outros, incluindo tumores intracranianos, que são responsáveis por apenas 0,3% desses casos. Os meningiomas são os tumores intracranianos assintomáticos e extra-axiais mais comuns e estão associados ao aparecimento de sintomas extrapiramidais no parkinsonismo secundário. Este trabalho relata um caso e traz uma revisão de literatura com todos os casos descritos em que os meningiomas foram a causa primária de uma síndrome parkinsoniana. Relato do caso: Paciente masculino de 58 anos com histórico de oscilações de humor e comportamento, embotamento afetivo, anedonia, falta de vontade, compulsão alimentar e isolamento social. Ele também desenvolveu hemiparesia esquerda, associada a tremor de repouso de alta amplitude e baixa frequência. Os sintomas foram associados a um meningioma parassagital parafalcino direito, cujo efeito de massa atinge o lobo frontal e os gânglios da base ipsilaterais. A ressecção cirúrgica foi realizada, resultando na resolução completa dos sintomas parkinsonianos e também do comportamento. Conclusões: Os sintomas parkinsonianos decorrentes de meningiomas são raros e sua apresentação clínica pode se apresentar como DP idiopática. Por isso, é importante sempre investigar o diagnóstico diferencial. Os médicos devem estar atentos a esta causa secundária de DP, uma vez que o tratamento, prognóstico e qualidade de vida são completamente diferentes daqueles pacientes com DP primária.

Palavras-chave

Síndrome Parkinsoniana; Meningioma; Parkinsonismo secundário; Tremor de repouso; Meningioma parassagital

Abstract

Background: Parkinson’s disease is the main primary cause of Parkinsonian syndrome, otherwise, other etiologies should be investigated when these symptoms appear. Secondary parkinsonism can be caused by intoxication, cerebrovascular and metabolic disorders, head trauma, infections, and others, including intracranial tumors, which are responsible for only 0.3% of these cases. Meningiomas are the most common asymptomatic and extra-axial intracranial tumors and associated with the appearance of extrapyramidal symptoms in secondary parkinsonism. A case is reported along with a literature review with all the cases described in which meningiomas were the primary cause of a parkinsonian syndrome. Case Presentation: Male patient, 58 years-old, with history of mood and behavior oscillations, affective dullness, anhedonia, lack of volition, binge eating and social isolation. He also developed left hemiparesis associated with high amplitude and low frequency resting tremor. The symptoms were associated with a right parafalcine parasagittal meningioma, which mass effect get over the frontal lobe and ipsilateral basal ganglia. The surgical resection was performed, resulting in complete resolution of parkinsonian symptoms and behavior. Conclusions: Parkinsonian symptoms due to meningiomas are rare and their clinical presentation can appear as idiopathic PD. Because of that, it is important to always to perform investigation of differential diagnosis. Clinicians must pay attention to this secondary cause of PD since the treatment, prognosis and quality of life are completely different from those patients with primary PD.

Keywords

Parkinsonian Syndrome; Meningioma; Secondary Parkinsonism; Resting tremor; Parasagittal meningioma

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1Medical student, Medicine Course, University Center FMABC – FMABC, Santo André, SP, Brazil.

2MD, MR, Medical Residency in Neurosurgery, Department of Neurosurgery, Santa Paula Hospital, São Paulo, SP, Brazil.

3Neurosurgeon, Department of Neurosurgery, Saúde de Caxias do Sul Hospital, Caixas do Sul, RS, Brazil.

4MD, PhD, Neurosurgeon, Department of Molecular Biology, College of Medicine from ABC – FMABC, Santo André – SP, Brasil.

 

Received Apr 19, 2022
Accepted Sep 23, 2022

JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

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