Neoplastic Parkinsonism: An illustrative case report

Pandit, Lekha; Raghotham, Ananthan; Chickabasaviah, Yasha T; Khandige, Ganesh; Shetty, Rohan

doi:10.4103/0972-2327.116933

Cited by 2 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous authors who presented cases with Parkinsonism as a symptom of basal ganglia lymphoma suggested interruption of striatal postsynaptic dopamine receptors. 5,6 The unique features of our patient are that she did not have classic MRI findings of a PCNSL but later evolved to classic MRI findings with T1 and T2 FLAIR hyperintesities with homogenous contrast enhancement. 13 Also, her CSF cytology and flow cytometry was negative for lymphoma, but her 14-3-3 protein was elevated with Creutzfeldt-Jakob disease in the differential diagnosis.…”

Section: Discussionmentioning

confidence: 84%

“…2 Despite the involvement of basal ganglia in CNS lymphomas, only a handful cases have been reported with movement disorders like segmental dystonia, choreoathetosis, and Parkinson's disease. [3][4][5][6][7][8] We presented an unusual case of gradually progressing Parkinsonism with an elevation of CSF 14-3-3 protein and atypical imaging findings found to have PCNSL.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Primary Central Nervous System Lymphoma Presenting as Parkinsonism with Atypical MRI Findings and Elevated 14-3-3 Protein

Nagarajan

Yerram

Digala

et al. 2020

JNRP

View full text Add to dashboard Cite

Primary central nervous system lymphoma (PCNSL) is a rare neoplasm with an incidence of 2 to 3% of all CNS malignancies. The diagnosis can be challenging, especially with atypical presentations. Movement disorders can be one of the rare presentations of PCNSL. Here, we present an unusual case of gradually progressing Parkinsonism with an elevation of cerebrospinal fluid (CSF) 14–3-3 protein and atypical imaging findings found to have PCNSL. A 76-year-old female patient presented with gait and intermittent speech difficulty. Initial workup revealed a contrast-enhancing lesion in the bilateral putamen and head of caudate without any mass effect. Her symptoms were rapidly progressed over 6 months and presented with mild dysarthria, bradykinesia, mild rigidity, and reduced left arm swinging. These features were consistent with Parkinsonism. The repeat imaging showed the progression of hyperintensities in the bilateral putamen. The patient underwent a stereotypic biopsy of the right caudate nucleus, which revealed PCNSL. She was treated with high-dose methotrexate and is currently in remission. Diagnosis of movement disorders remains clinical and rapid progression of symptoms, and atypical presentation must warrant further imaging and workup.

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Primary Central Nervous System Lymphoma Presenting as Parkinsonism with Atypical MRI Findings and Elevated 14-3-3 Protein

Nagarajan

Yerram

Digala

et al. 2020

JNRP

View full text Add to dashboard Cite

show abstract

Psychiatric Disturbance or Parkinsonism as a Presentation of CNS Lymphoma: Observational Retrospective Study and Review of Literature

Sharma¹,

Dube²,

Mountjoy³

et al. 2020

American Journal of Clinical Oncology

View full text Add to dashboard Cite

Objective: To evaluate the incidence of and characterize the presentation of neuropsychiatric symptoms and/or Parkinsonism as a presentation of central nervous system lymphoma (CNSL) in either its primary CNSL form or when it spreads to the brain in systemic diffuse large B-cell lymphoma (secondary CNSL). Patients and Methods: With Institutional Review Board approval we identified patients who had been treated at Mayo Clinic from 1998 to 2018 and were recorded to have a combination of ICD 9/10 codes for CNSL and various psychiatric diagnoses. Results: A total of 20 of the 232 patients (9%) were noted to have neuropsychiatric symptoms preceding diagnosis. The average age at diagnosis was 62, with even split for sex. The majority (85%) of patients had primary CNSL. The average duration of symptoms before the diagnosis was 4.8 months. Confusion (80%), depression (40%), apathy (30%), anxiety (30%), and agitation (30%) were the most common symptoms identified. The majority (65%) of patients had subcortical lesions followed by the frontal lobe (50%). Parkinsonism was identified in 5 of the 20 patients with 4 demonstrating resolution of symptoms with treatment of the lymphoma. Conclusions: Neuropsychiatric symptoms are a rare but notable symptom before the presentation of CNSL. There is an increasing awareness of neurological illness presenting as pure psychiatric disturbance, prompting the need to exclude organic and treatable diseases, particularly in elderly patients. Acknowledgment and diagnosis are important for an appropriate management as there is a significant impact on patient and caregiver quality of life.

show abstract

Neoplastic Parkinsonism: An illustrative case report

Cited by 2 publications

References 6 publications

Primary Central Nervous System Lymphoma Presenting as Parkinsonism with Atypical MRI Findings and Elevated 14-3-3 Protein

Primary Central Nervous System Lymphoma Presenting as Parkinsonism with Atypical MRI Findings and Elevated 14-3-3 Protein

Psychiatric Disturbance or Parkinsonism as a Presentation of CNS Lymphoma: Observational Retrospective Study and Review of Literature

Contact Info

Product

Resources

About