Treatment-induced leukoencephalopathy in primary CNS lymphoma presenting as lower body parkinsonism

Excerpt

Lower body parkinsonism (LBP) is a term coined to identify a relatively homogeneous subgroup of parkinsonism, distinct from idiopathic parkinson’s disease (PD) and characterized by gait difficulty with postural instability, freezing, lack of or minimal upper limb involvement, and poor response to levodopa. Although vascular etiology is highly predominant, LBP had been more rarely associated with other causes such as advanced PD and normal pressure hydrocephalus (NPH). We describe the case of a patient treated with chemoradiotherapy for a primary CNS lymphoma (PCNSL), who several years later presented a clinical picture strongly evocative of LBP. Neuroimaging studies showed diffuse subcortical white matter lesion suggesting radiotherapy-induced leukoencephalopathy. To our knowledge, this is the first case of clinically manifest LBP described in patients who received effective PCNSL therapy. …