Hemiballism in a patient with probable multiple system atrophy.
We report a patient with long-standing asymmetrical parkinsonism, cerebellar ataxia and dysautonomia, suggestive of multiple system atrophy (MSA). However, the patient also developed involuntary repetitive movements similar to ballic dyskinesias and mental deterioration. MRI revealed major involvement of both posterior fossa structures and basal ganglia. The case would be accommodated within a rubric of MSA widened to include involvement of the subthalamic nucleus and the medial part of the pallidum, pathology which may account for the ballic movements. Additionally the patient's cognitive and behavioural disturbances suggest an impairment of striato-prefrontal cortex loop.
Testa
D
D
Division of Neurology, C. Besta Institute of Neurology, Milan, Italy.
Grisoli
M
M
Monza
D
D
Girotti
F
F
D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000175:diagnosis; D001479:Basal Ganglia / Q000473:pathology; D001921:Brain / Q000473:pathology; D002524:Cerebellar Ataxia / Q000150:complications* / Q000175:diagnosis; D002819:Chorea / Q000150:complications*; D002908:Chronic Disease; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis