Case Report
Trigeminal Meningioma in a Patient with Tardive Dyskinesia as
Only Symptom
Maria-Gabriela Catans ,
1
Andreea-Alina Dan,
2
and Corina Roman-Filip
1,3
1
Clinical County Emergency Hospital of Sibiu, Department of Neurology, Romania
2
Clinical County Emergency Hospital of Sibiu, Department of Radiology, Romania
3
Lucian Blaga University of Sibiu, Faculty of Medicine, Romania
Correspondence should be addressed to Maria-Gabriela Catan˘ a; catanamariagabriela@gmail.com
Received 6 December 2018; Accepted 19 December 2018; Published 31 December 2018
Academic Editor: Norman S. Litofsky
Copyright © 2018 Maria-Gabriela Catan˘ a et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Most meningiomas are benign, encapsulated tumors (95% of the cases), generally undergoing a limited number of genetic
aberrations. We present the case of a 74-year-old patient with no signifcant pathological history, who is admitted to the neurology
ward for orofacial dyskinesias accompanied by hypoesthesia in the lef hemiface, a symptomatology that had started insidiously
about two months before and worsened progressively over the past 3 weeks. A cerebral MRI was performed which revealed a small
mass with discrete T2 hyperintensity and T1 iso-signal compared to the gray matter located in the lef pontine cistern, with a large,
well-defned base at the level of the cerebral tentorium. Te diagnosis of trigeminal meningioma was established and the treatment
was started, afer hearing the opinion of a neurosurgeon.
1. Introduction
Most meningiomas are benign, encapsulated tumors (95%
of the cases), generally undergoing a limited number of
genetic aberrations. Although they are the most common
central nervous system tumors (20% of all central nervous
system tumors), meningiomas have a rather poorly defned
incidence, epidemiology, and prognosis [1]. Tumor local-
ization is a critical factor in determining the prognosis,
therapeutic options, and especially the degree of resectability
of the tumor [2]. Despite benign tumors, meningiomas have
been reported to shorten survival rates. Te treatment of
choice for meningioma is surgical resection, but when the
tumor is difcult to approach anatomically, a symptomatic,
conservative treatment is preferred.
2. Case Presentation
We present the case of a 74-year-old patient with no signif-
icant pathological history, who is admitted to the neurology
ward for orofacial dyskinesias accompanied by hypoesthesia
in the lef hemiface, a symptomatology that had started insid-
iously about two months before and worsened progressively
over the past 3 weeks. Te objective general examination
revealed a normal weight patient with a relatively good gen-
eral condition when admitted to hospital, hemodynamically
stable-blood pressure (BP) = 130/70 mmHg, AV = 72 bpm,
and afebrile. Te neurological examination revealed such
changes as lef hemifacial hypoaesthesia, orofacial dyskinesia,
extrapyramidal syndrome, bradykinesia and bilateral hypoki-
nesia without motor defcits or coordination disorders, with-
out speech impediments, lef plantar extension, and right
plantar fexion. All laboratory test results were physiologically
within limits, which helped exclude a number of causes of
dyskinesia, such as thyroid pathology. However, the vast
diferential diagnosis of orofacial dyskinesia, which excluded
use of neuroleptics, demonstrated that it was imperative to
go to the next stage, namely, paraclinical tests. Te EEG
revealed no changes, so a cerebral MRI with contrast was
performed which revealed a small mass with discrete T2
hyperintensity (Figure 1) and T1 iso-signal compared to the
gray matter located in the lef pontine cistern, with a large,
Hindawi
Case Reports in Neurological Medicine
Volume 2018, Article ID 6175165, 3 pages
https://doi.org/10.1155/2018/6175165