Parkinsonism and extraocular motor abnormalities with unusual neuropathological findings

Authors

  • M. D. Vincent P. Calabrese,

    Corresponding author
    1. Departments of Neurology, Biochemistry, and Molecular Biophysics, Medical College of Virgina and the McGuire Veterans Administration Hospital, Richmond, Virginia, U.S.A.
    • Department of Neurology, MCV Station, Box 599, Medical College of Virginia, Richmond, VA 23298, U.S.A.
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  • M. Gary Hadfield

    1. Departments of Pathology (Neuropathology), Medical College of Virgina and the McGuire Veterans Administration Hospital, Richmond, Virginia, U.S.A.
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Abstract

Parkinsonian patients with ocular motility abnormalities are usually considered to have progressive supranuclear palsy. However, a number of other conditions have been noted to have the combination of parkinsonism and ocular problems. We report a case of rigid akinetic parkinsonism, oculomotor palsy, and eyelid apraxia with postmortem examination. Our findings are unusual in that there was marked gliosis of the substantia nigra with a large amount of free extracellular neuromelanin despite a 3-year clinical course. Only rare hyaline inclusion bodies and no neurofibrillary tangles were seen in the brainstem. Excessive calcification of the vessels of the globus pallidus were also noted. This case represents another example of the diversity of conditions producing parkinsonism with extraocular motor abnormalities.

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