Hemiparkinsonism-hemiatrophy syndrome.
OBJECTIVE
To characterize the clinical and radiologic features of hemiparkinsonism-hemiatrophy syndrome (HPHA).


METHODS
Medical records of patients with evidence of unilateral parkinsonism and ipsilateral body atrophy, evaluated at the Baylor College of Medicine Movement Disorders Clinic, were reviewed.


RESULTS
The mean age at onset of the 30 patients who satisfied the criteria was 44.2 (15 to 63) years with a mean duration of symptoms for 9.7 (2 to 20) years. Half of all patients had dystonia at onset and dystonia was present in 21 (70%) patients during the course of the syndrome. Eleven (37%) also had scoliosis. Brain asymmetry on imaging studies was noted in 9 (30%) patients. Response to levodopa was rated as good in 18, moderate in 6, and poor in 6. Nine of 19 (47%) patients in whom birth history was available had difficult birth or had severe febrile illness in the first few months of life. Overall 10 (33%) patients had difficulty in walking during early childhood.


CONCLUSIONS
Although the clinical features of hemiparkinsonism-hemiatrophy syndrome are variable, suggesting a heterogeneous pathogenesis, perinatal and early childhood cerebral injury appears to play an important role in about half of the cases.
Wijemanne
Subhashie
S
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Suite 1801, 6550 Fannin, Houston, TX 77030, USA.
Jankovic
Joseph
J
D000293:Adolescent; D000328:Adult; D001284:Atrophy / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D001720:Birth Injuries / Q000150:complications; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001925:Brain Damage, Chronic / Q000150:complications / Q000209:etiology / Q000503:physiopathology; D004421:Dystonia / Q000209:etiology / Q000503:physiopathology; D005121:Extremities / Q000473:pathology; D005150:Facial Hemiatrophy / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006130:Growth Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012600:Scoliosis / Q000209:etiology / Q000503:physiopathology; D003294:Seizures, Febrile / Q000150:complications; D013577:Syndrome