A rare case of parasagittal meningioma causing isolated foot drop: case report and review of the literature

Bilić, Hrvoje; Hančević, Mirea; Sitaš, Barbara; Bilić, Ervina

doi:10.1007/s13760-019-01255-8

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…First, this condition is extremely rare. To the best of our knowledge, to date, there have been only 9 cases with foot drop due to a parasagittal meningioma reported in English language [2, 6, 7], and only 2 patients with really isolated unilateral foot drop at the initial examination [4, 7]. In our country, for the first time, our 2 cases with this condition have been recorded.…”

Section: Discussionmentioning

confidence: 92%

“…In term of EMG results, our colleagues have found decreased maximal effort recruitment in paretic muscles but did not consider this finding as a presentation of central cause. In a case with a parasagittal meningioma reported by Bilić et al [7], reduced motor unit action potential recruitment was also noted, but the authors saw it as normal result. Indeed, recruitment abnormalities were observed both in the lower motor neuron lesions and in upper motor neuron diseases.…”

Section: Discussionmentioning

confidence: 96%

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Reasons for Diagnostic Delay of Foot Drop Caused by Parasagittal Meningioma: Two Case Reports

Nguyen

Nguyen²,

Hoang

et al. 2021

Case Rep Neurol

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Foot drop is defined as an impaired ability or inability of dorsiflexion. Peripheral nervous system injuries are commonly considered as the cause of this condition. The central causes including parasagittal meningioma are also described in the literature but very rarely and commonly not recognized early. In this article, we report 2 patients with isolated unilateral foot drop as the first symptom of a parasagittal meningioma and discuss several reasons for delayed diagnosis. Two patients were treated with decompressive craniotomy. The histopathological findings demonstrated a fibroblastic meningioma and a meningothelial meningioma. During postoperative follow-up, the woman patient showed nearly complete recovery and the second case regained total muscle power over a period of 12 months. The rarity of the disease, the absence of upper motor neuron signs, the occurrence of peripheral pathologies and misinterpretation of F wave on nerve conduction study, and motor unit recruitment on electromyography lead to delay in diagnosis and treatment of the central foot drop due to parasagittal meningioma.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 96%

Reasons for Diagnostic Delay of Foot Drop Caused by Parasagittal Meningioma: Two Case Reports

Nguyen

Nguyen²,

Hoang

et al. 2021

Case Rep Neurol

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Intracranial Funicular Sciatica

Akhaddar

2023

Atlas of Sciatica

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Giant Meningioma Diagnosis and Clinical Treatment: A Case Report

Valerio,

Santiago,

Fernandez Gomez

et al. 2024

Cureus

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This case report shows the importance of semiology during a clinical examination not only to diagnose spine clinical symptoms but also to review the central nervous system tumor as a foot drop cause. We report a unique case of a patient who consulted for constant progressive numbness and motor symptoms in the right lower extremity. Lumbar CT and MRI were negative for acute or chronic lumbar pathology. This is a 41-year-old female patient with a history of eight-month progressive right leg weakness. The physical examination did not reveal neurological alterations besides foot drop. MRI and lumbar X-rays showed no significant findings. Electromyography (EMG) indicated right peroneal neuropathy. Based on these findings, surgical treatment was not indicated; therefore, physical therapy and a referral to neurology were indicated. However, symptoms increased, resulting in a right lower extremity hemiparesis. A brain MRI showed a left frontoparietal giant meningioma, which was surgically resected after embolization. The patient evolved with a full recovery of the right-sided hemiparesis after surgery. Our case highlights the foot drop's multiple etiologies. Initially, a lumbar disc hernia was suspected, but it was ruled out by imaging studies. Later, the EMG revealed peroneal neuropathy, leading to a neurology consult. Unexpectedly, a giant intracranial meningioma was found, a rare case of foot drop. A consideration of upper motor neuron (UMN) and lower motor neuron (LMN) syndromes aided diagnosis. Tumoral resection with embolization resulted in significant improvement, showcasing the complexities of such cases. Foot drop is a peculiar clinical manifestation that must have an integral assessment to rule out peripheral and central causes. Even rare, giant meningiomas can cause focalized symptoms such as foot drop. Therefore, the assessment of foot drop should include the CT and MRI of the central nervous system.

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A rare case of parasagittal meningioma causing isolated foot drop: case report and review of the literature

Cited by 4 publications

References 12 publications

Reasons for Diagnostic Delay of Foot Drop Caused by Parasagittal Meningioma: Two Case Reports

Reasons for Diagnostic Delay of Foot Drop Caused by Parasagittal Meningioma: Two Case Reports

Intracranial Funicular Sciatica

Giant Meningioma Diagnosis and Clinical Treatment: A Case Report

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