Patient T.G., a woman of 70 years old from the rural area, is at her first admission to "Socola" Institute of Psychiatry Iasi, and comes to the hospital accompanied by her family, at the neurologist indication, for a symptomatology manifested by: negative hyperthymic mood, marked irritability, irascibility, reduced tolerance to minor frustrations, psycho-emotional lability, feelings of uselessness and despair, low self-esteem, diffuse anxiety, mixed insomnia, mnesic and prosexic disorders, interpretative ideation with mystical-religious theme in the patient's cultural context, volunteer laryngeal stridor, facial hemispasm, tremors of the extremities, paraparesis, various somatizations, marked difficulties in adapting, integrating and relating in the socio-familial environment.
During admission, the patient developed a facial hemispasm and a laryngeal stridor with hyperpnea and desaturation (SaO2=62%).
The physical examination notices left axillary enlarged lymph nodes, the presence of the laryngeal stridor, the facial hemispasm, vertigo, a decrease in visual and auditory acuity, hypotonia, hypotrophy and bradykinesia, impossible walking, the patient presenting paraparesis.
The neurological examination and laboratory tests (hematology, biochemistry) were repeated and a consult of physical medicine and recovery was performed, strengthening the following diagnoses: sciatic popliteal nerve palsy, cerebral lacunarism, non-surgical right temporal meningioma, facial hemispasm, intermittent laryngeal stridor.
In exceedingly rare cases, depending on cause, localization and extension, they can determine: headaches, dizziness, facial hemispasm
, trigeminal neuralgia, numbness, nausea, impaired balance, diplopia, tinnitus, aphasia, transient dysarthria, hydrocephalus, seizures, vasogenic edema.