Dystextia: An Early Sign of Pregnancy-Associated Meningioma

Objective: The authors report a case of meningioma causing incomprehensible and excessive text messaging in a postpartum woman. Case Report: We report the case of expressive dystextia related to a postpartum, progesterone receptor-positive meningioma. Growth of meningiomas can accelerate during pregnancy and the postpartum period due to expression of hormone receptors, particularly progesterone. This is the first study describing dystextia related to a brain tumor; previous cases of dystextia are associated with stroke and complex migraine. Here expressive dystextia, the inability to compose syntactically comprehensible text messages, preceded acute neurologic signs by several months, and surgical resection of the meningioma eliminated all neurologic sequelae. Possible genetic etiologies for meningioma are discussed since this patient’s prior thyroid cancer at age 18 suggests a relationship between the two neoplasms. Conclusions: Since text messaging is becoming one of the principal forms of communication in our society and requires both cognitive and motor skills, clinicians should be aware that dystextia may be the initial sign of significant neurologic pathology. We propose that an inquiry about altered text messaging frequency and comprehensibility should be a standard part of the neurologic evaluation.