Consider brain tumors with progressive supranuclear palsy-like phenotypes

This brief case study with MRI images suggests that brain tumors should be considered in the diagnostic workup of progressive supranuclear palsy-like phenotypes.

The patient, a 70-year-old woman, presented with a two-year history of progressive difficulty walking with frequent falls. Neurologic examination showed postural instability with backward falls, vertical supranucelar gaze palsy with normal vestibular-ocular reflex, rigidity, and pyramidal signs in the right limbs.

She demonstrated no clinical response to levodopa, and laboratory serologic tests were normal. However, MRI showed midbrain compression and dislocation caused by a large tumor in the left lateral ventricle. She died before neurosurgery was performed.