Hemiparkinsonism due to frontal meningioma

Area of Science:

• Neurology
• Neurosurgery
• Oncology

Background:

• Idiopathic Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor symptoms.
• Diagnostic criteria for PD often include clinical presentation and neuroimaging findings like dopamine transporter (DaT) scans.
• Differentiating PD from secondary parkinsonism is crucial for appropriate management.

Observation:

• A patient presented with right-sided hemiparkinsonism.
• Initial diagnosis at another institution suggested idiopathic PD based on family history, clinical signs, and asymmetric DaT scan.
• A frontal meningioma with surrounding edema compressing the basal ganglia was identified.

Findings:

• Surgical resection of the frontal meningioma led to complete resolution of parkinsonism symptoms.
• This indicates the tumor was the causative agent of the parkinsonism, not idiopathic PD.
• The case challenges the initial diagnosis despite fulfilling clinical criteria for idiopathic PD.

Implications:

• Structural neuroimaging is vital for diagnosing parkinsonism, even when clinical criteria for idiopathic PD are met.
• Meningiomas can present with parkinsonian symptoms, necessitating thorough investigation beyond standard PD workups.
• This case underscores the importance of considering secondary causes of parkinsonism.