Should we irradiate a brain tumor in a patient with parkinsonism? A case report and literature review

Parkinson’s Syndrome After Cranial Radiotherapy: A Case Report

Parkinson’s syndrome is a group of signs and symptoms where the core issue is bradykinesia and could be a manifestation of idiopathic parkinsonism (Parkinson's disease, PD), secondary parkinsonism, or parkinsonism due to neurodegenerative disease. PD is the most common cause of Parkinson's syndrome, accounting for approximately 80% of cases. The secondary causes of Parkinson's syndrome include tumors, trauma, hydrocephalus, chemotherapy, medications including amphotericin B, metoclopramide, and radiation treatment. Parkinsonian symptoms secondary to radiation treatment are rarely reported in the literature and are usually not alleviated by carbidopa-levodopa. This report describes a 64-year-old man diagnosed with low-grade astrocytoma of the midbrain who developed unilateral parkinsonian symptoms one year after chemoradiation treatment. This case report also sheds further light on the details of reported cases and the treatment options through an extensive literature review. Clinicians need to be aware of patients developing this rare complication following radiation treatment.