Superficial Siderosis Misdiagnosed As Parkinson’s Disease in a 70-year-old Male Breast Cancer Survivor

Abstract

A 70-year-old African American male with a history of hypertension, congestive heart failure, breast cancer status-post six rounds of doxorubicin/cyclophosphamide, and Parkinson's disease managed with carbidopa/levodopa presented to the emergency department with bilateral hearing loss and ataxia. The patient was admitted and evaluated for possible traumatic, oncological, and pharmacological etiologies. Further investigation revealed hypointensities along the cerebellar folia and basal cisterns on MRI in addition to the two-year history of progressive bilateral hearing loss and gait ataxia. In view of these findings, the patient was diagnosed with superficial siderosis and Parkinson's medications were discontinued. Superficial siderosis should be considered as a diagnosis in cases of bilateral hearing loss and ataxia in patients with history of anticoagulation and risk factors for prior cerebrovascular accidents or head trauma.