• PCNSL can mimic various secondary movement disorders. • Gait ataxia, parkinsonism, and chorea are the most frequent presentations. • Consider PCNSL in differential diagnosis of new-onset movement disorders at any age. Movement disorders (MD) can result from various mechanisms: central nervous system infection (20%), trauma (15%), metabolic dysregulation (7%), vascular causes (22%), or inflammatory, degenerative, and tumoral diseases. MD leading to the diagnosis of primary central nervous system lymphoma (PCNSL) are rare but may be treatable, depending on how quickly the diagnosis is made. The objective of this study was to explore movement disorders in PCNSL and discuss the potential pathophysiological relationships between PCNSL and symptoms. We conducted a systematic review from databases inception (PubMed/MEDLINE and Google Scholar) through July 2025. Forty-five cases were found in the literature. An additional case from our records was included, with detailed clinical and paraclinical examinations for illustrative purposes (a 77-year-old man who experienced subacute left hemichorea-hemiballism movements, leading to the discovery of a right-sided lesion involving deep brain structures). Globally, the main movement disorders included gait impairment/ataxia (48%), parkinsonism (20%), chorea/ballism (14%), and tremor (10%). The mean age at onset was 59 years (ranging from 24 to 81), and the sex ratio was 23 males to 23 females. PCNSL may present with unusual symptoms like movement disorders (which may be of various types). Early diagnosis could enable prompt initiation of urgent treatments.
Harlay et al. (Sun,) studied this question.