Unilateral akathisia and choreoathetosis as an unusual presentation of a frontal lobe dermoid cyst

Abstract

Objective

To consider an unusual presentation of a frontal lobe dermoid cyst. Intracranial masses very rarely present with movement disorders. We describe a highly unusual presentation of an intracranial dermoid with unilateral choreoathetosis, akathisia and facial tics.

Material

A 63-year-old man presented with left-sided akathisia and tardive dyskinesia of his upper limb, attributed to a dermoid cyst in the right frontal lobe. Resection of the cyst led to a complete resolution of his symptoms without neurological deficit.

Conclusion

Pathogenic mechanisms of such symptoms may include compression and ischaemia of the basal ganglia and other nigrostriatal structures, as well as dysfunction of the supplementary motor area and mesolimbic dopaminergic pathways.

Keywords:

• Dermoid cyst
• extrapyramidal
• movement disorder
• basal ganglia

Disclosure statement

Lindsey Bulleid and Christopher Wilcox were joint authors, and Tom Hughes and Paul Leach edited and supervised the article. All authors approved the final copy of the manuscript. The authors report no sources of financial and material support in the preparation of this article, and no conflicts of interest.