Hemichorea and dystonia due to frontal lobe meningioma

Area of Science:

• Neurology
• Neuro-oncology
• Movement Disorders

Background:

• Meningiomas, tumors arising from the meninges, are typically benign but can present with diverse neurological symptoms.
• While arteriovenous malformations are known to cause movement disorders, the association with meningiomas is less frequently reported.
• This case report addresses the infrequent presentation of movement disorders secondary to meningiomas.

Observation:

• A patient presented with involuntary, irregular movements (chorea) and abnormal posturing (dystonia) in the left extremities.
• Clinical examination revealed these movement abnormalities were associated with a heavily calcified right frontal lobe meningioma.
• The patient's symptoms suggest a direct or indirect effect of the tumor on motor pathways.

Findings:

• The meningioma, despite being benign and calcified, exerted mechanical pressure leading to complex movement disorders.
• The patient exhibited both choreiform and dystonic movements, demonstrating the potential for multiple movement disorder phenotypics from a single lesion.
• Brain imaging was crucial in identifying the meningioma as the underlying cause of the patient's movement abnormalities.

Implications:

• This case underscores the necessity of thorough brain imaging in the workup of unexplained movement disorders, even in the presence of a benign-appearing tumor.
• It emphasizes the importance of detailed neurological and movement disorder examinations to capture the full spectrum of symptoms caused by mass effect.
• The findings highlight the diverse clinical manifestations of meningiomas and their potential to mimic other neurological conditions.