We report on a clinicoanatomical analysis of five patients with structural midbrain lesions who shared severe nigrostriatal dopaminergic denervation but presented different involuntary movements. The main clinical phenotype was parkinsonism in only one case; it was choreoballism in three cases and tremor and dystonia in one case. Structural midbrain lesions are likely to involve structures additional to nigral dopaminergic neurons. The extent of extranigral involvement may determine the diverse clinical manifestations associated with the structural midbrain lesions.
Bibliographical noteFunding Information:
This study was supported by a grant of Seoul National University Hospital (03-2008-015). The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. HJK and BSJ had had full access to the data in the study and had final responsibility for the decision to submit for publication.
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