Since both my mother and grandmother have been found to have brain meningiomas, I have begun to take a very serious look at this matter. My search has lead me to find a few cases of meningioma – benign brain tumor arising from the lining covering of the brain (the meninges) presenting as reversible Parkinsonism. However, my concern is the relationship between PD and an increase risk for occurrence of meningioma’s of the brain after PD diagnosis.

My grandmother as you might remember had Parkinson’s disease which began in her late 60’s. She had good response to PD meds for many years but then began having uncontrolled bladder issues first believed to be due to PD but the symptoms were out of proportion to disease state. It was then thought that the problem was due to Diabetes. Then came the increase falling and worsening vision. This continued until one day she suddenly developed hemiparesis and seizures which led to the discovery of an extremely aggressive meningioma of which she died of.

My search has lead me to a possible link of an increased incidence of ‘benign tumors’ (non- aggressive and normally do not spread to surrounding tissues; although they can be serious and life threating) with PD, this according to a large Taiwanese PD study. The incidence appeared to be an increase of 2.2. Furthermore, the incidence of benign tumors was higher in women with PD compared to women without PD especially in those over 50 years of age. However, the problem is that they never mentioned which ‘benign’ brain tumors?

The most common ‘benign’ brain tumor in adults are pituitary adenomas after gliomas, meningiomas, and schwannomas. So it would stand to reason that some of these benign tumors are indeed meningiomas.

What does this all mean for us?

3 things:

  1. Meningioma’s could be a possible treatable cause of Parkinson’s disease (parkinsonism)- these can present anywhere in the brain. Hence, the importance of obtaining an MRI of the Brain when first diagnosed. These occur more commonly in women ages 30-70; so YOPD women should always look, as any other PD patient, look at other treatable causes.

Risks are:

  • Head injury (controversial)           
  •  Increase in progesterone (post- menopause
  •  Neurofibromatosis type 2 (genetic disorder)
  •  Exposure to radiation

2. Meningioma’s are a possible increased benign brain tumor in PD patients especially in women. Therefore, it is important to keep in the back of your mind and discuss with your physician if new symptoms arise especially if not responding to PD medications or occurring out suddenly or out of frame with expected PD course. This is a time to have a repeated MRI/CT of the Brain. MRI is recommended because they usually begin to have calcifications or changes in the bone and arise in areas where there are a lot of bony structures making it easier to overlook. Because these grow very slowly over time usually they present with gradually developing symptoms.

Symptoms: the hard part is that some of these symptoms are part of PD – thus we have to remain hypervigilant especially when not obtaining the desired affect from medication. (Not responding well)

  • Blurred vision/loss of vision/
  • Weakness in arms or legs
  • Numbness
  • Speech problems
  • Headaches
  • Seizures
  • (increased bladder/bowel function due to swelling when there is swelling of the brain)

3. Because benign brain tumors incidence has been reported to be increased in PD patients – until we have more defining studies even when all seems well maybe worthwhile to discuss with your physicians about an updated brain imaging to make sure some of the slow growing treatable tumors don’t sneak up on us. Furthermore, those of us who like me are LRRK2 carriers might be also at higher risk of another benign brain tumor a glioma.

Now, for a woman that was once proud of her brain it has been a big blow to watch my brain shrink since this disease took over me along with the realization that I may be at higher risk of having a brain tumor due to my genetics and family history. But, I will persevere and continue to fight and educate others in hope of a better tomorrow for all of us.

 

Sources:

http://www.ncbi.nlm.nih.gov/pubmed/23544297

increased risk of brain tumors with PD : http://www.ncbi.nlm.nih.gov/pubmed/26508469

meningioma brain tumors: http://www.webmd.com/cancer/brain-cancer/meningioma-causes-symptoms-treatment#1

large intracranial meningioma masquerading as PD:http://jnnp.bmj.com/content/early/2015/08/04/jnnp-2015-311531.short?rss=1