Journal of Neurology

, Volume 258, Issue 6, pp 1180–1182 | Cite as

Localisation of the applause sign in a patient with acute bilateral lenticular infarction

  • Richard A. Walsh
  • Joe Duggan
  • Tim LynchEmail author
Letter to the Editors

Dear Sirs,

The ‘applause sign’ refers to a tendency to initiate an automatic series of hand-claps despite instruction to clap three times only [1]. It is not specific for any one condition, but has been associated with progressive supranuclear palsy (PSP) in particular [2] and has also been described in corticobasal degeneration, multiple system atrophy and idiopathic Parkinson’s disease [3]. Localisation of the pathology that gives rise to the applause sign is uncertain. A combination of frontal cortical and basal ganglia dysfunction has been suggested. There has been one previous report of the applause sign in a patient without a known neurodegenerative disease. This occurred in a patient with diffuse B-cell lymphoma involving the putamen on one side; however, there was also extensive subcortical white matter disease bilaterally [4].

A 70-year-old man presented with sudden onset left hemiparesis. He was a diabetic with hypertension and hyperlipidemia. His family reported that he was...


Multiple System Atrophy Progressive Supranuclear Palsy Globus Pallidus Progressive Supranuclear Palsy Lentiform Nucleus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest


Supplementary material

Supplementary material 1 (WMV 4545 kb)


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Dublin Neurological InstituteMater Misericordiae University HospitalDublin 7Ireland
  2. 2.Department of Medicine for the Older PersonMater Misericordiae University HospitalDublin 7Ireland
  3. 3.Dublin Academic Medical CentreDublinIreland

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