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Hemiparkinsonism as a late complication of hemiatrophy

A new syndrome

Department of Neurological Sciences, Rush-Presbyterian-St. Lukes Medical Center, Chicago, IL.

Four men with evidence of hemiatrophy resulting from early-life hemispheral injury developed unilateral hemiparkinsonism on the side of the hemiatrophy. The parkinsonism began in the fourth decade and has remained unilateral for 5 to 35 years. In all four patients, the parkinsonism was slowly progressive, but the clinical response to levodopa was minimal, suggesting that the parkinsonism might have a postsynaptic striatal component. The clinical similarities of these four patients suggest that this is a distinct syndrome in which hemiparkinsonism is a late sequela of hemiatrophy. Identification of this syndrome has prognostic significance, because it seems to have a stereotyped course, remaining unilateral and only slowly progressive.

Address correspondence and reprint requests to Dr. Klawans, Rush-Presbyterian-St. Lukes Medical Center, Department of Neurological Sciences, 1725 West Harrison Street, Chicago, IL 60612.

This work was supported in part by grants from the United Parkinson Foundation, Chicago, IL, and the Boothroyd Foundation, Chicago, IL.

This paper was presented at the thirty-second annual meeting of the American Academy of Neurology, New Orleans, LA, May 1980.

Accepted for publication July 29, 1980.

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