• Ronald B. Postuma
  • Anthony E. Lang
Part of the Current Clinical Neurology book series (CCNEU)


Patient 1: A 69-year-old man was followed at the Toronto Western Hospital with a 7-year history of Parkinson’s disease (PD). Other past medical history included diabetes, coronary artery disease, and a previous stroke involving the right frontal lobe. Two weeks before presentation, he noticed the acute onset of involuntary movements of the left side, predominantly affecting the arm but also involving the leg and face. They tended to worsen soon after taking his levodopa. Clinical examination showed choreic movements of the left arm. Interestingly, the bradykinesia and rigidity were significantly ameliorated on the left side. Magnetic resonance imaging (MRI) examination demonstrated an infarction of the posterior putamen and globus pallidus, extending upwards into the periventricular white matter (seeFig. 1). Dopaminergic medications were decreased, resulting in improvement of his symptoms. During his admission, he began to have spontaneous improvement in symptoms, and did not require therapy.


Deep Brain Stimulation Subthalamic Nucleus Typical Neuroleptic Toronto Western Hospital Basal Ganglion Lesion 
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Copyright information

© Humana Press Inc. 2005

Authors and Affiliations

  • Ronald B. Postuma
    • 1
  • Anthony E. Lang
    • 1
  1. 1.Morton and Gloria Shulman Movement Disorder CenterToronto Western HospitalTorontoCanada

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