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Neurological picture
Large intracranial meningioma masquerading as Parkinson's disease
  1. Michael Fong1,
  2. Ali Ghahreman2,
  3. Lynnette Masters3,
  4. William Huynh3,4
  1. 1Blacktown Hospital and Clinical School, University of Western Sydney, Sydney, New South Wales, Australia
  2. 2Department of Neurosurgery, St George Hospital, Sydney, New South Wales, Australia
  3. 3Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
  4. 4Department of Neurology, Prince of Wales Hospital and Clinical School, Sydney, New South Wales, Australia
  1. Correspondence to Dr Michael Fong, Blacktown Hospital and Clinical School, University of Western Sydney, Sydney, New South Wales 2148, Australia; michaelfong1{at}gmail.com

https://doi.org/10.1136/jnnp-2015-311531

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    A previously healthy 58-year-old right-handed woman presented with a 2-month history of progressive asymmetrical extrapyramidal symptoms and signs suggestive of idiopathic Parkinson's disease. On examination, she had moderate hypomimic facies with hypophonic speech. She had a reduced right arm swing and a slow gait, although it was neither festinated nor shuffling and had a normal base. A resting pill-rolling tremor of about 3–5 Hz was evident in the distal right upper limb affecting the thumb and wrist, as well as an intermittent low-amplitude and low-frequency tremor of her jaw. There was no associated postural, kinetic or intention component to the tremor. In addition, cogwheel rigidity of the wrist, and bradykinesia of rapid finger movements were observed on the right. The resting tremor and cogwheel rigidity was accentuated …

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    Footnotes

    • Contributors MF and WH were involved in the management and care of the patient and preparation and drafting of the manuscript. AG was involved in the management and care of the patient. LM was involved in the management and care of the patient and selection of the figures.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.