Transient parkinsonism after unilateral midbrain stroke: a compensatory intervention from the healthy side?

Excerpt

A 69-year-old man was admitted in our department because of acute onset of left hemiparesis. The neurological examination, apart from the weakness and hypoesthesia in left limbs (NIHSS, National Institute of Health Stroke Scale = 5), also revealed moderate extrapyramidal signs, definitely absent before admission. Indeed patient had an abnormal diminution of facial expression, moderately impaired speech, mild bradykinesia on the right side proven with finger-tapping, open–close and prono-supination hand movements and foot-tapping. Brain magnetic resonance imaging (MRI), performed few days after the onset, showed an ischemic lesion of the right portion of midbrain with involvement of right cerebral peduncle. Therefore, patient was properly cared for the stroke, thus he had a normal clinical course and was discharged in a week. …