Meningioma presenting as bilateral parkinsonism

Abstract

Background: A 63-year-old woman presented with an 18-year history of tremor, rigidity and akinesia. There was no response to treatment with either levodopa or pergolide. Later a focal neurological deficit developed, which led to a diagnosis of fronto-parietal meningioma. Outcome: Surgical excision of the meningioma abolished the parkinsonism. Conclusion: Cerebral tumour is an uncommon cause of parkinsonism. Symptoms probably occur due to compression and distortion of the basal ganglia and nigrostriatal pathway. Diagnosis of the underlying pathology can be delayed by this presentation. Since complete recovery is possible parkinsonian patients with atypical symptoms, poor response to dopaminergic drugs, and focal neurological signs should undergo neuroimaging.