Session Information
Date: Wednesday, June 7, 2017
Session Title: Phenomenology and Clinical Assessment Of Movement Disorders
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: To describe a case of a 60-year-old female that presented with cognitive decline and gait disorders for the last 7 years.
Background: The patient had been diagnosed with bipolar disorder 30 years ago with alternating episodes of depression and mania and had been treated with antidepressants and antipsychotics. Neuroimaging was normal at that time. The family had noticed deterioration in gait and cognitive decline for the past 7 years, which became severe the last two years. On suspicion of drug induced parkinsonism she had been treated with anticholinergics with no improvement. Although treatment was altered and quatiepine was introduced, no amelioration was noticed.
Methods: The patient was admitted to the Outpatient Clinic of Neurological Department of Papageorgiou General Hospital. Cognition along with movement were impaired. Apathy was prominent and responses to simple questions were slow. Clinical evaluation revealed postural instability, difficulty in rising from a seat and a positive pull test. Further examination revealed dystonic phenomena, rigidity and bradykinesia on the left part of the body. She also presented apraxia and frontal executive dysfunction of the left upper limb. Saccadic movements were slow with deterioration of upward gaze.
Results: On the basis of clinical characteristics, corticobasal syndrome was diagnosed. Due to overlapping phenotypes of various causes of corticobasal syndrome and in order to investigate treatable causes, neuroimaging was performed. MRI revealed an extra-axial tumor with subtle adjacent edema. Excessive mass phenomena produced severe midline shift. On T1 C+ (Gd) enhancement was intense and inhomogenous.
Conclusions: Psychiatric patients consist a group that requires caution in making decisions about neurological disorders, especially when it comes to extrapyramidal syndromes. In addition, brain tumors can produce a number of neurological symptoms and signs that mimic various situations, like corticobasal syndrome. Reevaluation in case of doubt is critical as there are treatable conditions that should be diagnosed without delay.
To cite this abstract in AMA style:
P. Tsitsi, G. Xiromerisiou, T. Kalantzakou, T. Bourinaris, G. Deretzi. Corticobasal syndrome due to brain tumor [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/corticobasal-syndrome-due-to-brain-tumor/. Accessed June 15, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/corticobasal-syndrome-due-to-brain-tumor/