Bilateral Thalamic Glioma. Case Report.

Uchino, Masafumi; Kitajima, Satoru; Miyazaki, Chikao; Shibata, Iekado; Miura, Myota

doi:10.2176/nmc.42.443

Cited by 18 publications

(12 citation statements)

References 13 publications

(13 reference statements)

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“…By performing an extensive review of the literature and updating the already presented series (2,8,21), we can state that a total of 59 cases have been published to the best of our knowledge (excluding the present case).…”

Section: █ Discussionmentioning

confidence: 79%

“…Unfortunately, the early stages of the disease are silent, with the patients having mild signs and symptoms even with large tumors (14). Symptoms mainly comprise mental deterioration, personality changes, and apathy, rather than focal neurological signs (17,21). This is not the case of pediatric patients who rarely present with personality disorders even in the case of large tumors (4,8).…”

Section: █ Discussionmentioning

confidence: 99%

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Bilateral thalamic glioma - case report and review

Bălaşa¹,

Balasa²,

Egyed-Zsigmond³

et al. 2014

Turkish Neurosurgery

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diagnosis reported as 3 years in patients with grade II BLTG (2,10).We present the case of a BLTG manifesting with fast progressive cognitive dysfunction leading to dementia in an elderly patient. █ CASE REpORTA 72-year-old right handed male, treated only for essential arterial hypertension stage I, presented 3 months prior to admittance, with gradual deterioration of the cognitive functions and intermittently aggressive behavior towards close relatives. The symptoms progressed gradually, with the patient not being able to perform basic everyday tasks and presenting periods of extreme agitation. █ INTRODUCTIONPrimary thalamic gliomas are rare and have been presented in recent reports with an incidence of 0.84-5.2% among all intracranial tumors (2,4,15,18).Bilateral thalamic gliomas (BLTG) constitute a unique intracranial tumoral pathology typically manifested by varying degrees of personality disorder. The rate of BLTG is much lower than that of unilateral thalamic glioma and cannot be objectively expressed in any way at present (4-7,13).Imaging in BLTG is typical and reveals large tumors with symmetrical and strictly limited involvement of bilateral thalami, without any apparent connecting tumoral tissue (2).The prognosis of BLTG is poor and a rapid fatal evolution has been observed (14) with the longest period of survival after the Bilateral thalamic glioma is extremely rare and the incidence cannot be adequately expressed. We present the case of a 72 years old male suffering from the rapid deterioration of cognitive function to moderately severe dementia in a short period of time. Magnetic resonance studies demonstrated a bilateral thalamic glioma with a minimal focal gadolinium uptake in the left thalamus. Biopsy was performed and pathology report was of anaplastic astrocytoma, WHO grade III. Radiotherapy was proposed but was rejected by the patient's relatives. The patient deceased 57 days later. We performed an extensive review of the literature and by updating the previous described series we can state that to the best of our knowledge this is the 60th case described in the literature and the second eldest patient presented. Patients suffering from this disease present a poor prognosis, the longest survival described being of 3 years in patients diagnosed with grade II bilateral thalamic glioma. Adjuvant therapy in form of radiotherapy to the thalami is most commonly used but the benefits are unclear. The natural progression of WHO grade III bilateral thalamic glioma left untreated, as can be seen from our case, has an even poorer outcome.

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Section: █ Discussionmentioning

confidence: 79%

Section: █ Discussionmentioning

confidence: 99%

Bilateral thalamic glioma - case report and review

Bălaşa¹,

Balasa²,

Egyed-Zsigmond³

et al. 2014

Turkish Neurosurgery

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“…Bithalamic tumors (BTs) can be distinguished clinically and radiologically from other gliomas (Uchino, Kitajima, Miyazaki, Shibata, & Miura, 2002), as they may be characterized by the nearly symmetrical enlargement of both thalamic nuclei without any apparent interconnecting tumor tissue. BTs are a very rare neoplasm, yet their actual incidence is unknown; moreover, clinical manifestations, natural history, and prognosis remain relatively obscure (Gelabert-González, SeramitoGarcía, Bandín-Diéguez, & Allutt, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Behavioral impairments including personality changes, confusion, memory loss, apathy, emotional instability, and dementia (Uchino et al, 2002) are described as typical manifestations of these tumors. Gutmann, Grossman, and Mollman (1990) speculated that these symptoms may result from dysfunctions of the dorsomedial nuclei, which receive connections from the amygdala and temporal neocortex and project on to the prefrontal area (Gelabert-González et al, 2007;Gutmann et al, 1990;Uchino et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

“…Gutmann, Grossman, and Mollman (1990) speculated that these symptoms may result from dysfunctions of the dorsomedial nuclei, which receive connections from the amygdala and temporal neocortex and project on to the prefrontal area (Gelabert-González et al, 2007;Gutmann et al, 1990;Uchino et al, 2002). In particular, dementia and personality changes are attributed to the damage to these thalamic nuclei, because of their connections with the temporal and frontal lobes.…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychological Deterioration Predicts Tumor Progression in a Young Boy With Bithalamic Glioma

Peruzzi

Iuvone

Ruggiero

et al. 2015

Applied Neuropsychology: Child

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A description is given of the clinical, neuropsychological, and neuroimaging evolution of a 12-year-old boy (CG) who presented with bilateral thalamic astrocytoma (World Health Organization Grade 2). CG underwent an extensive neuropsychological assessment immediately after biopsy prior to any medical therapies and was followed up for 3 years until death. Neuropsychological functioning was thoroughly investigated by means of a detailed battery that included intelligence and cognitive functions. Evolution was characterized by cognitive deterioration that preceded neuroimaging signs of tumor progression. Starting from normal cognitive organization, the child exhibited visuospatial memory deficits and, afterward, diffuse cognitive impairment. The role of neuropsychological assessment in detecting early disease progression is discussed, mainly for rare pathologies whose evolution may be extremely variable.

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Bilateral thalamic glioma presenting with parkinsonism

et al. 2009

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The majority of motor parasomnias and almost all nocturnal seizures occur out of NREM sleep. 1,2 The only well-defined disorders that are exclusively REM related are REM sleep behavior disorder (RBD) 3 and painful nocturnal erections. Catathrenia is a disorder that arises mostly but not exclusively out of REM. 4 There is also a single case report of periodic movements in sleep (PMS) occurring predominantly in REM. 5 Otherwise, the medical literature is sparse on reports of REM dependant motor parasomnias. We report an unusual case of a stereotypical REM sleep motor parasomnia.A 54-year-old man presented with a 5-year history of complex, stereotypical, and nocturnal movements that were disruptive to his wife's sleep and minimally to his as well. They tended to occur several times a week usually 4 hours into sleep and repeated approximately every 30 seconds for about an hour. Their semiology, according to his wife, did not change from night to night. He aroused easily from these and was immediately alert without any dream recall. These were not triggered either by sleep deprivation or stress. The next day he was not sleepy (Epworth sleepiness scale score 5/24), but fatigued and had sore upper extremities and neck muscles.Medical and family histories were noncontributory. He was only on antihypertensives and allopurinol. Physical examination was unremarkable.An MRI of the brain was normal. A polysomnogram (PSG) was done with 16 EEG channels, 2 EOG channels, 2 mentalis EMG channels, thermistor, pressure transducer, chest and abdomen effort belts, oximetry, 1 channel ECG, 2 bilateral tibialis anterior (TA) EMG channels, and a snore microphone. The PSG was significant only for mild positional obstructive sleep apnea with a total AHI of 10/hr, supine AHI of 22/hr, and lateral AHI of 1/hr. No PLMS occurred. No events occurred on the night of the PSG and his muscle tone was appropriately suppressed in REM sleep.The patient was monitored overnight. The previous montage was replicated with the exception of the TA electrodes, snore microphone, and the thermistor. Thirteen distinct typical events, of 3 seconds duration each, were captured, all arising from REM sleep. Three of the events occurred in the first REM period of the night at a frequency of one every 30 seconds. Three of the second REM period with a frequency of 1 per minute, another two at the beginning of the third and

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Bilateral Thalamic Glioma. Case Report.

Cited by 18 publications

References 13 publications

Bilateral thalamic glioma - case report and review

Bilateral thalamic glioma - case report and review

Neuropsychological Deterioration Predicts Tumor Progression in a Young Boy With Bithalamic Glioma

Bilateral thalamic glioma presenting with parkinsonism

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