Slowly progressive Parkinson syndrome due to thalamic butterfly astrocytoma.

摘要

A 74-year-old man had a 4-year history of slowly progressive asymmetric resting tremor, hypokinesia, rigidity, and postural instability and mild cognitive decline, initially diagnosed as Parkinson disease. Clinical response to levodopa was moderate (video on the Neurology~R Web site at www.neurology.org). Additional pyramidal signs developed; cranial MRI showed a symmetric bilateral tumor of the thalamus and brainstem (figure, A and B).