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Asymmetric predominantly ipsilateral blepharospasm and contralateral parkinsonism in an elderly patient with a right mesencephalic cyst
Author(s) -
Singer Carlos,
Schatz Norman J.,
Bowen Brian,
Eidelberg David,
Kazumata Ken,
Sternau Linda,
Shulman Lisa M.,
Weiner William J.
Publication year - 1998
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.870130125
Subject(s) - blepharospasm , parkinsonism , medicine , midbrain , magnetic resonance imaging , lesion , central nervous system disease , positron emission tomography , psychology , anatomy , surgery , radiology , pathology , central nervous system , disease , botulinum toxin
Abstract A 66‐year‐old woman presented with a 3‐year history of predominantly right‐sided blepharospasm and a 1‐year history of progressive predominantly left‐sided hemiparkinsonism manifested by a left upper extremity resting tremor and left‐sided bradykinesia. Magnetic resonance imaging of the brain revealed a large right mesencephalic cyst with mass effect. Positron emission tomography revealed bilateral striatal hypometabolism consistent with nigrostriatal dopaminergic dysfunction. The association of predominantly ipsilateral blepharospasm and predominantly contralateral hemiparkinsonism is very rare, and its association with a posterior fossa space‐occupying lesion has been reported only once. This is the second report of such an association and the first description of adult‐onset symptomatology.