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A 42-year-old right-handed woman presented with a 1 year history of headache, localised in both frontoparietal regions, and a 6 month history of left-sided tremor and clumsiness; depression was another notable symptom of this patient. Neurological examination revealed left hemiparkinsonism, characterised by mixed tremor (postural, action and intermittent rest tremor) in both extremities, hypomimia, bradykinesia, cogwheel rigidity and loss of arm swing during gait on the left hand side. Deep tendon reflexes were brisk on the left side with a positive Babinski sign. The Unified Parkinson's Disease Rating Scale motor …
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Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.