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Cedergren Weber G, Timpka J, Rydelius A, Bengzon J, Odin P. Tumoral parkinsonism-Parkinsonism secondary to brain tumors, paraneoplastic syndromes, intracranial malformations, or oncological intervention, and the effect of dopaminergic treatment. Brain Behav 2023; 13:e3151. [PMID: 37433071 PMCID: PMC10454247 DOI: 10.1002/brb3.3151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
INTRODUCTION Secondary tumoral parkinsonism is a rare phenomenon that develops as a direct or indirect result of brain neoplasms or related conditions. OBJECTIVES The first objective was to explore to what extent brain neoplasms, cavernomas, cysts, paraneoplastic syndromes (PNSs), and oncological treatment methods cause parkinsonism. The second objective was to investigate the effect of dopaminergic therapy on the symptomatology in patients with tumoral parkinsonism. METHODS A systematic literature review was conducted in the databases PubMed and Embase. Search terms like "secondary parkinsonism," "astrocytoma," and "cranial irradiation" were used. Articles fulfilling inclusion criteria were included in the review. RESULTS Out of 316 identified articles from the defined database search strategies, 56 were included in the detailed review. The studies, which were mostly case reports, provided research concerning tumoral parkinsonism and related conditions. It was found that various types of primary brain tumors, such as astrocytoma and meningioma, and more seldom brain metastases, can cause tumoral parkinsonism. Parkinsonism secondary to PNSs, cavernomas, cysts, as well as oncological treatments was reported. Twenty-five of the 56 included studies had tried initiating dopaminergic therapy, and of these 44% reported no, 48% low to moderate, and 8% excellent effect on motor symptomatology. CONCLUSION Brain neoplasms, PNSs, certain intracranial malformations, and oncological treatments can cause parkinsonism. Dopaminergic therapy has relatively benign side effects and may relieve motor and nonmotor symptomatology in patients with tumoral parkinsonism. Dopaminergic therapy, particularly levodopa, should therefore be considered in patients with tumoral parkinsonism.
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Affiliation(s)
- Gustav Cedergren Weber
- Division of Neurology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversityLundSweden
- Department of Neurology, Rehabilitation Medicine, Memory and GeriatricsSkåne University HospitalLundSweden
| | - Jonathan Timpka
- Division of Neurology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversityLundSweden
- Department of Neurology, Rehabilitation Medicine, Memory and GeriatricsSkåne University HospitalLundSweden
| | - Anna Rydelius
- Division of Neurology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversityLundSweden
- Department of Neurology, Rehabilitation Medicine, Memory and GeriatricsSkåne University HospitalLundSweden
| | - Johan Bengzon
- Division of Neurosurgery, Department of Clinical Sciences, Kamprad laboratoryLund UniversityLundSweden
- Department of NeurosurgerySkåne University HospitalLundSweden
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversityLundSweden
- Department of Neurology, Rehabilitation Medicine, Memory and GeriatricsSkåne University HospitalLundSweden
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Reddy KK, Anderson MD, Vijayakumar S, Vengaloor Thomas T. Parkinson’s Syndrome After Cranial Radiotherapy: A Case Report. Cureus 2022; 14:e24411. [PMID: 35619842 PMCID: PMC9126036 DOI: 10.7759/cureus.24411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2022] [Indexed: 11/12/2022] Open
Abstract
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.
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Höllerhage M. Secondary parkinsonism due to drugs, vascular lesions, tumors, trauma, and other insults. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 149:377-418. [PMID: 31779822 DOI: 10.1016/bs.irn.2019.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In addition to neurodegenerative disorders, there are many secondary forms of parkinsonism. The most common cause for secondary parkinsonism is the intake of distinct drugs. Neuroleptics and calcium channel blockers have been mainly described to induce parkinsonism, but also other drugs were suspected to cause or worsen parkinsonism. Another common cause for secondary parkinsonism are vascular lesions (i.e. vascular parkinsonism). Furthermore, also brain tumors have been described as rare causes for parkinsonism. Moreover, parkinsonism can be caused by chronic traumatic encephalopathy, which is a special case, since secondary insults to the brain leads to the occurrence of a neuropathologically defined disease. Other rare causes for secondary parkinsonism are lesions caused by infectious or immunological diseases as well as toxins or street drugs.
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Affiliation(s)
- Matthias Höllerhage
- Department for Neurology Hannover Medical School (MHH), Hannover, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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Joutsa J, Horn A, Hsu J, Fox MD. Localizing parkinsonism based on focal brain lesions. Brain 2019; 141:2445-2456. [PMID: 29982424 DOI: 10.1093/brain/awy161] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/19/2018] [Indexed: 01/20/2023] Open
Abstract
Bradykinesia, rigidity, and tremor frequently co-occur, a clinical syndrome known as parkinsonism. Because this syndrome is commonly seen in Parkinson's disease, symptoms are often attributed to cell loss in the substantia nigra. However, parkinsonism occurs in several other neurological disorders and often fails to correlate with nigrostriatal pathology, raising the question of which brain region(s) cause this syndrome. Here, we studied cases of new-onset parkinsonism following focal brain lesions. We identified 29 cases, only 31% of which hit the substantia nigra. Lesions were located in a variety of different cortical and subcortical locations. To determine whether these heterogeneous lesion locations were part of a common brain network, we leveraged the human brain connectome and a recently validated technique termed lesion network mapping. Lesion locations causing parkinsonism were functionally connected to a common network of regions including the midbrain, basal ganglia, cingulate cortex, and cerebellum. The most sensitive and specific connectivity was to the claustrum. This lesion connectivity pattern matched atrophy patterns seen in Parkinson's disease, progressive supranuclear palsy, and multiple system atrophy, suggesting a shared neuroanatomical substrate for parkinsonism. Lesion connectivity also predicted medication response and matched the pattern of effective deep brain stimulation, suggesting relevance as a treatment target. Our results, based on causal brain lesions, lend insight into the localization of parkinsonism, one of the most common syndromes in neurology. Because many patients with parkinsonism fail to respond to dopaminergic medication, these results may aid the development of alternative treatments.10.1093/brain/awy161_video1awy161media15815555971001.
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Affiliation(s)
- Juho Joutsa
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Neurology, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | - Andreas Horn
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Charité - Universitätsmedizin, Berlin, Germany
| | - Joey Hsu
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michael D Fox
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Oliveira HSD, de Oliveira PS, Calil V, Macêdo PJOM, Canedo N, Vasconcellos LFR. A 77-year-old man with parkinsonism and rapidly progressive dementia. Brain Pathol 2018; 28:777-778. [PMID: 30375117 DOI: 10.1111/bpa.12653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | | | - Victor Calil
- Institute of Neurology, Federal University of Rio de Janeiro, Brazil
| | | | - Nathalie Canedo
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Brazil
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Parvaresh M, Azar M, Ghalaenovi H, Fattahi A. Parkinsonism: a rare manifestation of craniopharyngioma. Electron Physician 2015; 7:1027-31. [PMID: 26120410 PMCID: PMC4477761 DOI: 10.14661/2015.1027-1031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/26/2015] [Indexed: 12/03/2022] Open
Abstract
Craniopharyngioma is a non-glial, non-malignant intracranial tumor of ectodermal origin, which arises from a remnant of Rathke’s pouch. This tumor accounts for 5.6 to 13% of intracranial tumors in children. This paper discusses a case of craniopharyngioma in a five-year-old boy. An MRI scan of his brain showed a huge sella and supra sella cystic-solid lesion that had invaded the prepontine and interpeduncular cisterns, filling of 3rd ventricle and hydrocephalus. The patient operated via interhemispheric subfrontal through lamina terminalis and the tumor dissected from all part of brain stem and total resection achieved. After surgery Parkinsonism was worse for 3 days and levodopa started for 3 days. Parkinsonism was gone and after one week levodopa discontinued. This case practically implied that decompression of mass effect of tumor on brain stem and short-term management with levodopa can improve Parkinsonism due to midline compressive brain tumors without basal ganglia involvement.
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Affiliation(s)
- Mansour Parvaresh
- Assistant Professor, Neurosurgery ward of Rasool-e-Akram Hospital Complex, Department of Neurosurgery, Iran University of Medical Science, Tehran, Iran
| | - Maziar Azar
- Associate Professor, Neurosurgery ward of Rasool-e-Akram Hospital Complex, Department of Neurosurgery, Iran University of Medical Science, Tehran, Iran
| | - Hossein Ghalaenovi
- Assistant Professor, Neurosurgery ward of Rasool-e-Akram Hospital Complex, Department of Neurosurgery, Iran University of Medical Science, Tehran, Iran
| | - Arash Fattahi
- Medical Doctor, Resident of Neurosurgery, Neurosurgery ward of Rasool-e-Akram Hospital Complex, Department of Neurosurgery, Iran University of Medical Science, Tehran, Iran
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Kuiper M, Hendrikx S, Koehler PJ. Headache and Tremor: Co-occurrences and Possible Associations. Tremor Other Hyperkinet Mov (N Y) 2015; 5:285. [PMID: 26175954 PMCID: PMC4472994 DOI: 10.7916/d8p55mkx] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 05/12/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Tremor and headache are two of the most prevalent neurological conditions. This review addresses possible associations between various types of tremor and headache, and provides a differential diagnosis for patients presenting with both tremor and headache. METHODS Data were identified by searching MEDLINE in February 2015, with the terms "tremor" and terms representing the primary headache syndromes. RESULTS Evidence for an association between migraine and essential tremor is conflicting. Other primary headaches are not associated with tremor. Conditions that may present with both tremor and headache include cervical dystonia, infectious diseases, hydrocephalus, spontaneous cerebrospinal fluid leaks, space-occupying lesions, and metabolic disease. Furthermore, both can be seen as a side effect of medication and in the use of recreational drugs. DISCUSSION No clear association between primary headaches and tremor has been found. Many conditions may feature both headache and tremor, but rarely as core clinical symptoms at presentation.
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Jang W, Ha SH, Khang SK, Kim J, Kim SH, Kim HJ. Juvenile parkinsonism as an initial manifestation of gliomatosis cerebri. J Neurol 2013; 260:3161-3. [DOI: 10.1007/s00415-013-7162-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/11/2013] [Accepted: 09/20/2013] [Indexed: 10/26/2022]
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Rocha H, Cerejo A, Garrett MC, Massano J. Reversible parkinsonism due to a large intracranial tumour. BMJ Case Rep 2012; 2012:bcr-2012-007823. [PMID: 23266782 DOI: 10.1136/bcr-2012-007823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A 77-year-old woman presented with progressively worsening apathy, depression, urinary incontinence and slowness of movement for the past 1 year. Asymmetric akinetic-rigid parkinsonism and mild left-sided hyper-reflexia were seen on examination. No ocular movement impairment, cerebellar or sensory signs were noticed. Routine laboratory testing was normal. Brain imaging revealed a large frontal tumour which was subsequently excised and pathologically confirmed as a meningioma. Marked clinical improvement was documented 3 months after surgery, and persistent clinical and imaging remission have been confirmed annually for the following 3 years. There have been some reports of parkinsonism associated with intracranial tumours. Although this is probably an uncommon situation, it is potentially treatable, and symptoms might even remit completely following successful management. Parkinson's disease is a common cause of parkinsonism, but alternative aetiologies should be suspected whenever atypical findings are demonstrated by clinical history or examination.
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Affiliation(s)
- Helena Rocha
- Department of Neurology, Centro Hospitalar de São João, Oporto, Portugal
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Akhaddar A, Mandour C, Belhachmi A, Boucetta M. Chronic headache and hemiparkinsonism due to a sylvian fissure dermoid cyst. Headache 2010; 50:479-80. [PMID: 20456142 DOI: 10.1111/j.1526-4610.2010.01617.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ali Akhaddar
- Department of Neurosurgery, Mohammed V Military Teaching Hospital, University of King Mohammed V-Souissi, Rabat, Morocco
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Añaños MV, Baringo T, Lievano P, De la Cueva L, Navarro P, Arroyo E, Gonzalez M, Abos D. Tumoural denervation of the nigrostriatal pathway. Eur J Nucl Med Mol Imaging 2009; 36:2092. [DOI: 10.1007/s00259-009-1278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 08/28/2009] [Indexed: 10/20/2022]
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