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Keywords:

  • Parkinson's disease;
  • Blepharospasm;
  • Dystonia;
  • Lesion;
  • Computed tomography;
  • Positron emission tomography;
  • Magnetic resonance imaging

Abstract

A patient developed progressive right hemidystonia in childhood. Subsequently, left-sided blephaospasm, slurred and stuttering speech, and right-sided rigidity and bradykinesia, responsive to dopamine agonists, appeared. Investigation with computed tomography and magnetic resonance imaging (MRI) at age 43 years revealed a left-sided calcified rostral brainstem-thalamic lesion of uncertain aetiology. Although no structural lesion was seen in the striatal regions, L-[18F]-fluorodopa uptake was severely diminished in the left striatum but normal on the right. Dopamine receptor binding identified by [11C]-methylspiperone was in the normal range on both sides.