Objective: To present the unusual occurrence of movement disorders (MD) secondary to cerebral cavernous malformations (CCM).

Background: CCM most frequently become manifest by seizures, focal neurologic deficits and headaches. MDs secondary to CCM have only been rarely described in thalamic, basal ganglia and brainstem CCM. Owing to their rarity, the natural history and optimal treatment of associated MDs remains unclear.

Method: In this study we included all patients with MD associated to a CCM that presented in our department over a period of 10 years.

Results: We encountered a total of 6 patients (5 women and 1 man). Mean age was 38,5 years (range: 16-77 years). In all cases radiographic signs of previous haemorrhage was evident. MDs included following with CCMs in various locations: hemiparkinsonism – anterolateral pontomesencephalon (1); chorea – subthalamic region (1); tremor – subthalamic region/dentothalamic pathways (2); dystonia – putamen/thalamomesencephalic region (2). Two patients underwent surgical removal of the CCM with subsequent resolution of MDs. One patient had radiosurgery with disappearance of tremor but occurrence of spasticity. In three patients with moderate severity of MDs a wait-and-see strategy was adopted.

Conclusion: Treatment of MDs secondary to CCM is challenging because of their location. The optimal strategy can be chosen only on an individual basis. Location of the CCM, bleeding history, symptom severity and duration are factors that should be considered. Surgery remains a primary therapeutic option possibly providing cure in experienced neurosurgical centers. Stereotactic radiosurgery can be used in deep-seated or surgically inaccessible CCM.

References: Ghaemi K, Krauss JK, Nakamura M. Hemiparkinsonism due to a pontomesencephalic cavernoma: improvement after resection. Case report. J Neurosurg Pediatr. 2009;4(2):143-6.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/cerebral-cavernous-malformations-and-movement-disorders/