Giant Intra-Ventricular Calcified Meningioma in Childhood Manifest as Movement Disorders : A Extremely Rare Presentation

 Meningioma is considered as distant differential diagnosis in intraventricular tumour especially in pediatric age except for few published case reports. Its clinical presentation as movement disorder which improves after few months of surgery is even a rare manifestation of disease. We present a case of giant intraventricular meningioma of more than 5 cm in eleven year old boy who clinically manifested as involuntary non rhythmic, non-repetitive, abnormal movements on left side of body which never reported before. These are quite challenging cases for surgeon.A 10 years boy presented with abnormal movement of left half of body which used to aggravate on motion from last 2 years. Abnormal movements were started in upper limb followed by lower limb and progressed from distal to proximal in limbs. These involuntary movements are irregular, non-rhythmic; non repetitive in left half of body with slow writhing movement of fingers and toes on left side. Importantly, these unsynchronized movements which were more on left upper than lower limbs and more aggravated on holding object or during other physical activity. These movements gradually worsened and progressively hampering his routine activities. The arm was involved more than the lower limb. On examination, higher mental function and cranial nerves were intact with mini-mental score was 26/30 except bilateral papilledema.