In 1988 Straube and Sigel1 reported on a 56 year old patient with a bilateral Parkinson′s syndrome, including resting tremor, rigidity, bradykinesia, and a favourable response to levodopa medication, starting at the age of 51 years. This patient was discovered to have a tumour (low grade astrocytoma grade II-III) in the left hemisphere, mainly involving the supplementary motor area. Based on the low chance that both Parkinson’s disease and astrocytoma occurred at the same time in this young patient (estimated probability 0.005%–0.1%), it was postulated that the tumour in the supplementary motor area induced the bilateral parkinsonian syndrome, although the levodopa responsiveness was unusual. Importantly, however, the supplementary motor area is considered to represent one of the critical motor areas which are establishing the motor circuit through the basal ganglia.2 3 We now report that this patient has …