Gliomatosis cerebri differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Gliomatosis cerebri must be differentiated from progressive multifocal leukoencephalopathy, multiple sclerosis, Marburg disease, multicentric glioblastoma, primary CNS lymphoma, viral encephalitis, acute disseminated encephalomyelitis, CNS vasculitis, Behçet's disease, venous sinus thrombosis, stroke, Gerstmann syndrome, leptomeningeal gliomatosis, Alzheimer's disease, Lewy body dementia, and parkinsonism.

Differentiating Gliomatosis cerebri from other Disease

Gliomatosis cerebri must be differentiated from:[1][2][3][4]

  • Gliomatosis cerebri must be differentiated from other diseases that cause clumsiness, progressive weakness, visual and speech changes and personality changes such as progressive multifocal leukoencephalopathy and leptomeningeal gliomatosis. Gliomatosis cerebri has more prominent long tract signs commonly involving corticospinal and spinocerebellar defects.
  • Gliomatosis cerebri must be differentiated from other diseases that cause memory loss, visuospatial defects, loss of executive function including cognitive and functional impairment such as alzheimers disease, lewy body dementia and parkinsonism. Gliomatosis cerebri may have the same exact features but are more subacute than the mentioned diseases.
  • Gliomatosis cerebri must be differentiated from other diseases that causes acute focal neurological deficits including hemiparesis, diplopia, aphasia and sensory changes such as a stroke, Gerstman syndrome, primary CNS lymphoma, multicentric glioblastoma and venous sinus thrombosis. Gliomatosis cerebri may have the same features but may not point to a single localizing area of affectation on brain imaging as it involves the brain diffusely (more than three lobes).
  • Gliomatosis cerebri must be differentiated from other diseases that cause headaches, malaise, weight loss and other constitutional symptoms such as CNS vasculitis and Behcets disease. Gliomatosis cerebri rarely present with inflammatory signs and symptoms.
  • Gliomatosis cerebri must be differentiated from other diseases that cause optic neuritis and other symptoms dessiminated in time and space such as multiple scleosis. Gliomatosis cerebri have a subacutely declining course rather than the typical relapsing-remitting course seen in majority of the case of multiple sclerosis.
  • Gliomatosis cerebri must be differentiated from other diseases that cause headaches, blurred vision, still neck, vomiting and nausea such asviral enchephalitis, meningitis and acute disseminated encephalomyelitis. These diseases are inflammatory in nature and they present acutely while gliomatosis cerebri present subacutely.

References

  1. Differential diagnosis of gliomatosis cerebri. Dr Henry Knipe and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/gliomatosis-cerebri
  2. Duron E, Lazareth A, Gaubert JY, Raso C, Hanon O, Rigaud AS (2008). "Gliomatosis cerebri presenting as rapidly progressive dementia and parkinsonism in an elderly woman: a case report". J Med Case Rep. 2: 53. doi:10.1186/1752-1947-2-53. PMC 2263063. PMID 18284707.
  3. Brandão RA, de Carvalho GT, de Azeredo Coutinho CA, Christo PP, Santiago CF, Santos Mdo C; et al. (2011). "Gliomatosis cerebri: diagnostic considerations in three cases". Neurol India. 59 (1): 122–5. doi:10.4103/0028-3886.76892. PMID 21339680.
  4. Desclée P, Rommel D, Hernalsteen D, Godfraind C, de Coene B, Cosnard G (2010). "Gliomatosis cerebri, imaging findings of 12 cases". J Neuroradiol. 37 (3): 148–58. doi:10.1016/j.neurad.2009.12.001. PMID 20334921.


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