Abstract
IntroductionDementia is one of the most important neurological disorders in the elderly. Dementia of tumoral origin is rare and parkinsonism of neoplastic origin is unusual. We herein report a case of gliomatosis cerebri, a very rare brain tumor seldom affecting the elderly, which presented as rapidly progressive dementia and parkinsonism.Case presentationAn 82-year-old woman very rapidly developed progressive dementia and akineto-rigid parkinsonism. Brain CT scan was normal. Cerebral magnetic resonance imaging (MRI) with gadolinium injection highlighted a diffuse tumor-related infiltration involving both lobes, the putamen, the pallidum, the substantia nigra, and the brainstem, corresponding to the specific description and definition of gliomatosis cerebri.ConclusionThis atypical presentation of a gliomatosis cerebri, and the infiltration of the substantia nigra by the tumor, merits attention.
Highlights
Dementia is one of the most important neurological disorders in the elderly
We report a case of probable gliomatosis cerebri, a very rare brain tumor seldom affecting the elderly, which presented as rapidly progressive dementia and parkinsonism
Tumours of the basal ganglia are rarely accompanied by parkinsonism [9], which is why brain lymphomas are frequently seen to involve basal ganglia, but without symptoms of parkinsonism [10]
Summary
Dementia is one of the most important neurological disorders in the elderly. In occidental countries, the most common forms of dementia are Alzheimer's disease and vascular dementia, with frequencies of 70 and 15%, respectively. Secondary parkinsonism is frequent among elderly people. We report a case of probable gliomatosis cerebri, a very rare brain tumor seldom affecting the elderly, which presented as rapidly progressive dementia and parkinsonism. The physical examination at the time of admission revealed an akineto-rigid bilateral, symmetrical parkinsonism. Her gait demonstrated marked reduction in arm swing. She displayed bilateral bradykinesia, limb rigidity and hypomimia. An electro-encephalogram demonstrated slow waves, especially at the level of the left temporal lobe. Allowing for this dementia with parkinsonism, the first diagnostic hypothesis was dementia with Lewy bodies. The patient died of urinary sepsis just before the initiation of chemotherapy
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