Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1989 Jun;52(Suppl):55–67. doi: 10.1136/jnnp.52.suppl.55

Neuropathology in movement disorders.

W R Gibb 1
PMCID: PMC1033309  PMID: 2547027

Abstract

This review concentrates on the definition and classification of degenerative movement disorders in which Parkinsonian symptoms are often prominent. The pathological spectrum and clinical manifestations of Lewy body disease are described, and associations with Alzheimer's disease and motor neuron disease are explored. A classification of pallidonigral degenerations is based on clinical features, distribution of pathology, and morphological abnormalities; some of these patients have mild nigral degeneration and no Parkinsonian features. Many other juvenile and familial Parkinsonian cases are not included among the pallidonigral degenerations. Most of these latter syndromes have been organised into preliminary groups, in particular, autosomal dominant dystonia-Parkinson syndrome, juvenile Parkinsonian disorder and autosomal dominant Lewy body disease.

Full text

PDF
55

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADAMS R. D., VANBOGAERT L., VANDEREECKEN H. STRIATO-NIGRAL DEGENERATION. J Neuropathol Exp Neurol. 1964 Oct;23:584–608. [PubMed] [Google Scholar]
  2. Adler D., Horoupian D. S., Towfighi J., Gandolfi A., Suzuki K. Status marmoratus and Bielschowsky bodies. A report of two cases and review of the literature. Acta Neuropathol. 1982;56(1):75–77. doi: 10.1007/BF00691185. [DOI] [PubMed] [Google Scholar]
  3. Arai N., Amano N., Iseki E., Yokoi S., Saito A., Takekawa Y., Misugi K. Tardive dyskinesia with inflated neurons of the cerebellar dentate nucleus. Case reports and morphometric study. Acta Neuropathol. 1987;73(1):38–42. doi: 10.1007/BF00695500. [DOI] [PubMed] [Google Scholar]
  4. Averback P. Two new lesions in Alzheimer's disease. Lancet. 1983 Nov 19;2(8360):1203–1203. doi: 10.1016/s0140-6736(83)91256-4. [DOI] [PubMed] [Google Scholar]
  5. Beppu H., Nagaoka M., Tanaka R. Analysis of cerebellar motor disorders by visually-guided elbow tracking movement. 2. Contribution of the visual cues on slow ramp pursuit. Brain. 1987 Feb;110(Pt 1):1–18. doi: 10.1093/brain/110.1.1. [DOI] [PubMed] [Google Scholar]
  6. Bernheimer H., Birkmayer W., Hornykiewicz O., Jellinger K., Seitelberger F. Brain dopamine and the syndromes of Parkinson and Huntington. Clinical, morphological and neurochemical correlations. J Neurol Sci. 1973 Dec;20(4):415–455. doi: 10.1016/0022-510x(73)90175-5. [DOI] [PubMed] [Google Scholar]
  7. Boller F., Boller M., Gilbert J. Familial idiopathic cerebral calcifications. J Neurol Neurosurg Psychiatry. 1977 Mar;40(3):280–285. doi: 10.1136/jnnp.40.3.280. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Bugiani O., Perdelli F., Salvarani S., Leonardi A., Mancardi G. L. Loss of striatal neurons in Parkinson's disease: a cytometric study. Eur Neurol. 1980;19(5):339–344. doi: 10.1159/000115172. [DOI] [PubMed] [Google Scholar]
  9. Burkhardt C. R., Filley C. M., Kleinschmidt-DeMasters B. K., de la Monte S., Norenberg M. D., Schneck S. A. Diffuse Lewy body disease and progressive dementia. Neurology. 1988 Oct;38(10):1520–1528. doi: 10.1212/wnl.38.10.1520. [DOI] [PubMed] [Google Scholar]
  10. Carmichael S. W., Wilson R. J., Brimijoin W. S., Melton L. J., 3rd, Okazaki H., Yaksh T. L., Ahlskog J. E., Stoddard S. L., Tyce G. M. Decreased catecholamines in the adrenal medulla of patients with parkinsonism. N Engl J Med. 1988 Jan 28;318(4):254–254. doi: 10.1056/NEJM198801283180415. [DOI] [PubMed] [Google Scholar]
  11. Christensen E., Moller J. E., Faurbye A. Neuropathological investigation of 28 brains from patients with dyskinesia. Acta Psychiatr Scand. 1970;46(1):14–23. doi: 10.1111/j.1600-0447.1970.tb02097.x. [DOI] [PubMed] [Google Scholar]
  12. Clark A. W., White C. L., 3rd, Manz H. J., Parhad I. M., Curry B., Whitehouse P. J., Lehmann J., Coyle J. T. Primary degenerative dementia without Alzheimer pathology. Can J Neurol Sci. 1986 Nov;13(4 Suppl):462–470. doi: 10.1017/s0317167100037136. [DOI] [PubMed] [Google Scholar]
  13. Contamin F., Escourolle R., Nick J., Mignot B. Atrophie pallido-nigro-luysienne. Syndrome akinétique avec palilalie, rigidité oppositonnelle et catatonie. Rev Neurol (Paris) 1971 Feb;124(2):107–120. [PubMed] [Google Scholar]
  14. DAVISON C. Pallido-pyramidal disease. J Neuropathol Exp Neurol. 1954 Jan;13(1):50–59. doi: 10.1097/00005072-195401000-00007. [DOI] [PubMed] [Google Scholar]
  15. Delisle M. B., Gorce P., Hirsch E., Hauw J. J., Rascol A., Bouissou H. Motor neuron disease, parkinsonism and dementia. Report of a case with diffuse Lewy body-like intracytoplasmic inclusions. Acta Neuropathol. 1987;75(1):104–108. doi: 10.1007/BF00686799. [DOI] [PubMed] [Google Scholar]
  16. Dickson D. W., Davies P., Mayeux R., Crystal H., Horoupian D. S., Thompson A., Goldman J. E. Diffuse Lewy body disease. Neuropathological and biochemical studies of six patients. Acta Neuropathol. 1987;75(1):8–15. doi: 10.1007/BF00686786. [DOI] [PubMed] [Google Scholar]
  17. Duvoisin R. C., Nicklas W. J., Ritchie V., Sage J., Chokroverty S. Low leukocyte glutamate dehydrogenase activity does not correlate with a particular type of multiple system atrophy. J Neurol Neurosurg Psychiatry. 1988 Dec;51(12):1508–1511. doi: 10.1136/jnnp.51.12.1508. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Eidelberg D., Sotrel A., Joachim C., Selkoe D., Forman A., Pendlebury W. W., Perl D. P. Adult onset Hallervorden-Spatz disease with neurofibrillary pathology. A discrete clinicopathological entity. Brain. 1987 Aug;110(Pt 4):993–1013. doi: 10.1093/brain/110.4.993. [DOI] [PubMed] [Google Scholar]
  19. Ezrin-Waters C., Resch L. The nucleus basalis of Meynert. Can J Neurol Sci. 1986 Feb;13(1):8–14. doi: 10.1017/s0317167100035721. [DOI] [PubMed] [Google Scholar]
  20. Forno L. S. Concentric hyalin intraneuronal inclusions of Lewy type in the brains of elderly persons (50 incidental cases): relationship to parkinsonism. J Am Geriatr Soc. 1969 Jun;17(6):557–575. doi: 10.1111/j.1532-5415.1969.tb01316.x. [DOI] [PubMed] [Google Scholar]
  21. Gibb W. R., Lees A. J. A comparison of clinical and pathological features of young- and old-onset Parkinson's disease. Neurology. 1988 Sep;38(9):1402–1406. doi: 10.1212/wnl.38.9.1402. [DOI] [PubMed] [Google Scholar]
  22. Gibb W. R., Lees A. J. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry. 1988 Jun;51(6):745–752. doi: 10.1136/jnnp.51.6.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Gray F., De Baecque C., Serdaru M., Escourolle R. Pallido-luyso-nigral atrophy and amyotrophic lateral sclerosis. Acta Neuropathol Suppl. 1981;7:348–351. doi: 10.1007/978-3-642-81553-9_99. [DOI] [PubMed] [Google Scholar]
  24. Gray F., Eizenbaum J. F., Gherardi R., Degos J. D., Poirier J. Luyso-pallido-nigral atrophy and amyotrophic lateral sclerosis. Acta Neuropathol. 1985;66(1):78–82. doi: 10.1007/BF00698300. [DOI] [PubMed] [Google Scholar]
  25. Hirano A., Nakano I., Kurland L. T., Mulder D. W., Holley P. W., Saccomanno G. Fine structural study of neurofibrillary changes in a family with amyotrophic lateral sclerosis. J Neuropathol Exp Neurol. 1984 Sep;43(5):471–480. doi: 10.1097/00005072-198409000-00002. [DOI] [PubMed] [Google Scholar]
  26. Horowitz G., Greenberg J. Pallido-pyramidal syndrome treated with levodopa. J Neurol Neurosurg Psychiatry. 1975 Mar;38(3):238–240. doi: 10.1136/jnnp.38.3.238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Iizuka R., Hirayama K., Maehara K. A. Dentato-rubro-pallido-luysian atrophy: a clinico-pathological study. J Neurol Neurosurg Psychiatry. 1984 Dec;47(12):1288–1298. doi: 10.1136/jnnp.47.12.1288. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Jankovic J., Kirkpatrick J. B., Blomquist K. A., Langlais P. J., Bird E. D. Late-onset Hallervorden-Spatz disease presenting as familial parkinsonism. Neurology. 1985 Feb;35(2):227–234. doi: 10.1212/wnl.35.2.227. [DOI] [PubMed] [Google Scholar]
  29. Jellinger K., Jirásek A. Neuroaxonal dystrophy in man: character and natural history. Acta Neuropathol. 1971;5(Suppl):3–16. doi: 10.1007/978-3-642-47449-1_2. [DOI] [PubMed] [Google Scholar]
  30. Jellinger K. Progressive pallidumatrophie. J Neurol Sci. 1968 Jan-Feb;6(1):19–44. doi: 10.1016/0022-510x(68)90123-8. [DOI] [PubMed] [Google Scholar]
  31. Joachim C. L., Morris J. H., Selkoe D. J. Clinically diagnosed Alzheimer's disease: autopsy results in 150 cases. Ann Neurol. 1988 Jul;24(1):50–56. doi: 10.1002/ana.410240110. [DOI] [PubMed] [Google Scholar]
  32. Kato T., Hirano A., Katagiri T., Sasaki H., Yamada S. Neurofibrillary tangle formation in the nucleus basalis of Meynert ipsilateral to a massive cerebral infarct. Ann Neurol. 1988 Jun;23(6):620–623. doi: 10.1002/ana.410230617. [DOI] [PubMed] [Google Scholar]
  33. Kato T., Hirano A., Kurland L. T. Asymmetric involvement of the spinal cord involving both large and small anterior horn cells in a case of familial amyotrophic lateral sclerosis. Clin Neuropathol. 1987 Mar-Apr;6(2):67–70. [PubMed] [Google Scholar]
  34. Kato T., Katagiri T., Hirano A., Sasaki H., Arai S. Sporadic lower motor neuron disease with Lewy body-like inclusions: a new subgroup? Acta Neuropathol. 1988;76(2):208–211. doi: 10.1007/BF00688105. [DOI] [PubMed] [Google Scholar]
  35. Kilroy A. W., Paulsen W. A., Fenichel G. M. Juvenile Parkinsonism treated with levodopa. Arch Neurol. 1972 Oct;27(4):350–350. doi: 10.1001/archneur.1972.00490160078009. [DOI] [PubMed] [Google Scholar]
  36. Kosaka K., Matsushita M., Oyanagi S., Uchiyama S., Iwase S. Pallido-nigro-luysial atrophy with massive appearance of corpora amylacea in the CNS. Acta Neuropathol. 1981;53(2):169–172. doi: 10.1007/BF00689999. [DOI] [PubMed] [Google Scholar]
  37. Kosaka K., Oyanagi S., Matsushita M., Hori A., Iwase S. Multiple system degeneration and involving thalamus, reticular formation, pallido-nigral, pallido-luysian and dentato-rubral systems. A case report. Acta Neuropathol. 1977 Jul 15;39(1):89–95. doi: 10.1007/BF00690390. [DOI] [PubMed] [Google Scholar]
  38. Kosaka K., Shibayama H., Kobayashi H., Hoshino T., Iwase S. [An autopsy case of unclassifiable presenile dementia]. Seishin Shinkeigaku Zasshi. 1973 Jan;75(1):18–34. [PubMed] [Google Scholar]
  39. LANGE E., POPPE W. KLINISCHER BEITRAG ZUM KRANKHEITSBILD DER PROGRESSIVEN PALLIDUMATROPHIE (VAN BOGAERT) Psychiatr Neurol (Basel) 1963;146:176–192. [PubMed] [Google Scholar]
  40. LIPKIN L. E. Cytoplasmic inclusions in ganglion cells associated with parkinsonian states: a neurocellular change studied in 53 cases and 206 controls. Am J Pathol. 1959 Nov-Dec;35:1117–1133. [PMC free article] [PubMed] [Google Scholar]
  41. Lange E., Poppe W., Scholtze P. Familial progressive pallidum atrophy. Eur Neurol. 1970;3(5):265–267. doi: 10.1159/000113978. [DOI] [PubMed] [Google Scholar]
  42. Larsen T. A., Dunn H. G., Jan J. E., Calne D. B. Dystonia and calcification of the basal ganglia. Neurology. 1985 Apr;35(4):533–537. doi: 10.1212/wnl.35.4.533. [DOI] [PubMed] [Google Scholar]
  43. Lima B., Neves G., Nora M. Juvenile Parkinsonism: clinical and metabolic characteristics. J Neurol Neurosurg Psychiatry. 1987 Mar;50(3):345–348. doi: 10.1136/jnnp.50.3.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. MCCORMICK W. F., LEMMI H. FAMILIAL DEGENERATION OF THE PALLIDONIGRAL SYSTEM. Neurology. 1965 Feb;15:141–153. doi: 10.1212/wnl.15.2.141. [DOI] [PubMed] [Google Scholar]
  45. Martin W. E., Resch J. A., Baker A. B. Juvenile parkinsonism. Arch Neurol. 1971 Dec;25(6):494–500. doi: 10.1001/archneur.1971.00490060028003. [DOI] [PubMed] [Google Scholar]
  46. Mata M., Dorovini-Zis K., Wilson M., Young A. B. New form of familial Parkinson-dementia syndrome: clinical and pathologic findings. Neurology. 1983 Nov;33(11):1439–1443. doi: 10.1212/wnl.33.11.1439. [DOI] [PubMed] [Google Scholar]
  47. Mayer J. M., Mikol J., Haguenau M., Dellanave J., Pépin B. Familial juvenile parkinsonism with multiple systems degenerations. A clinicopathological study. J Neurol Sci. 1986 Jan;72(1):91–101. doi: 10.1016/0022-510x(86)90038-9. [DOI] [PubMed] [Google Scholar]
  48. Miyoshi K., Matsuoka T., Mizushima S. Familial holotopistic striatal necrosis. Acta Neuropathol. 1969;13(3):240–249. doi: 10.1007/BF00690644. [DOI] [PubMed] [Google Scholar]
  49. Mizutani T., Oda M., Abe H., Fukuda S., Oikawa H., Kosaka K. Hereditary multisystemic degeneration with unusual combination of cerebellipetal, dentato-rubral, and nigro-subthalamo-pallidal degenerations. Clin Neuropathol. 1983;2(4):147–155. [PubMed] [Google Scholar]
  50. Morin P., Lechevalier B., Bianco C. Atrophie cérébelleuse et lésions pallido-luyso-nigriques avec corps de lewy. Rapports avec la dégénérescence pallido-luyso-nigrique. Rev Neurol (Paris) 1980;136(5):381–390. [PubMed] [Google Scholar]
  51. Naidu S., Wolfson L. I., Sharpless N. S. Juvenile parkinsonism: a patient with possible primary striatal dysfunction. Ann Neurol. 1978 May;3(5):453–455. doi: 10.1002/ana.410030518. [DOI] [PubMed] [Google Scholar]
  52. Neumann M. A. A comparative study of Parkinsonism and other extrapyramidal system disorders. J Neuropathol Exp Neurol. 1968 Jan;27(1):152–153. [PubMed] [Google Scholar]
  53. Nygaard T. G., Duvoisin R. C. Hereditary dystonia-parkinsonism syndrome of juvenile onset. Neurology. 1986 Nov;36(11):1424–1428. doi: 10.1212/wnl.36.11.1424. [DOI] [PubMed] [Google Scholar]
  54. OKAZAKI H., LIPKIN L. E., ARONSON S. M. Diffuse intracytoplasmic ganglionic inclusions (Lewy type) associated with progressive dementia and quadriparesis in flexion. J Neuropathol Exp Neurol. 1961 Apr;20:237–244. doi: 10.1097/00005072-196104000-00007. [DOI] [PubMed] [Google Scholar]
  55. OTA Y., MIYOSHI S., UEDA O., MUKAI T., MAEDA A. Familial paralysis agitans juvenilis; a clinical, anatomical and genetic study. Folia Psychiatr Neurol Jpn. 1958 Jul;12(2):112–121. doi: 10.1111/j.1440-1819.1958.tb00623.x. [DOI] [PubMed] [Google Scholar]
  56. Okeda R., Kayano T., Funata N., Kojima T., Miki M., Iwama H. [An autopsy case of Parkinson's disease associated clinically with dementia terminating in akinetic mutism and pathologically with multiple Lewy's Bodies in the cerebral cortex]. No To Shinkei. 1982 Aug;34(8):761–767. [PubMed] [Google Scholar]
  57. Perry T. L., Norman M. G., Yong V. W., Whiting S., Crichton J. U., Hansen S., Kish S. J. Hallervorden-Spatz disease: cysteine accumulation and cysteine dioxygenase deficiency in the globus pallidus. Ann Neurol. 1985 Oct;18(4):482–489. doi: 10.1002/ana.410180411. [DOI] [PubMed] [Google Scholar]
  58. Popovitch E. R., Wisniewski H. M., Kaufman M. A., Grundke-Iqbal I., Wen G. Y. Young adult-form of dementia with neurofibrillary changes and Lewy bodies. Acta Neuropathol. 1987;74(1):97–104. doi: 10.1007/BF00688346. [DOI] [PubMed] [Google Scholar]
  59. Powers J. M., Horoupian D. S., Schaumburg H. H. Wetherbee ail. Documentation of a neurological disease in a Vermont family 90 years later. Can J Neurol Sci. 1974 May;1(2):139–140. [PubMed] [Google Scholar]
  60. Probst A., Sandoz P., Vanoni C., Baumann J. U. Intraneuronal polyglucosan storage restricted to the lateral pallidum (Bielschowsky bodies). A golgi, light, and electron microscopic study. Acta Neuropathol. 1980;51(2):119–126. doi: 10.1007/BF00690453. [DOI] [PubMed] [Google Scholar]
  61. Quinn N., Critchley P., Marsden C. D. Young onset Parkinson's disease. Mov Disord. 1987;2(2):73–91. doi: 10.1002/mds.870020201. [DOI] [PubMed] [Google Scholar]
  62. Rajput A. H., Rozdilsky B., Hornykiewicz O., Shannak K., Lee T., Seeman P. Reversible drug-induced parkinsonism. Clinicopathologic study of two cases. Arch Neurol. 1982 Oct;39(10):644–646. doi: 10.1001/archneur.1982.00510220042009. [DOI] [PubMed] [Google Scholar]
  63. Rebeiz J. J., Kolodny E. H., Richardson E. P., Jr Corticodentatonigral degeneration with neuronal achromasia. Arch Neurol. 1968 Jan;18(1):20–33. doi: 10.1001/archneur.1968.00470310034003. [DOI] [PubMed] [Google Scholar]
  64. Roessmann U., Schwartz J. F. Familial striatal degeneration. Arch Neurol. 1973 Nov;29(5):314–317. doi: 10.1001/archneur.1973.00490290054005. [DOI] [PubMed] [Google Scholar]
  65. SPELLMAN G. G. Report of familial cases of parkinsonism. Evidence of a dominant trait in a patient's family. JAMA. 1962 Feb 3;179:372–374. doi: 10.1001/jama.1962.03050050062014. [DOI] [PubMed] [Google Scholar]
  66. STEELE J. C., RICHARDSON J. C., OLSZEWSKI J. PROGRESSIVE SUPRANUCLEAR PALSY. A HETEROGENEOUS DEGENERATION INVOLVING THE BRAIN STEM, BASAL GANGLIA AND CEREBELLUM WITH VERTICAL GAZE AND PSEUDOBULBAR PALSY, NUCHAL DYSTONIA AND DEMENTIA. Arch Neurol. 1964 Apr;10:333–359. doi: 10.1001/archneur.1964.00460160003001. [DOI] [PubMed] [Google Scholar]
  67. STROBOS R. R., DE LA TORRE E., MARTIN J. F. Symmetrical calcification of the basal ganglia with familial ataxia and pigmentary macular degeneration. Brain. 1957 Sep;80(3):313–318. doi: 10.1093/brain/80.3.313. [DOI] [PubMed] [Google Scholar]
  68. Sachdev K. K., Singh N., Krishnamoorthy M. S. Juvenile parkinsonism treated with levodopa. Arch Neurol. 1977 Apr;34(4):244–245. doi: 10.1001/archneur.1977.00500160058010. [DOI] [PubMed] [Google Scholar]
  69. Serratrice G. T., Toga M., Pellissier J. F. Chronic spinal muscular atrophy and pallidonigral degeneration: report of a case. Neurology. 1983 Mar;33(3):306–310. doi: 10.1212/wnl.33.3.306. [DOI] [PubMed] [Google Scholar]
  70. Sima A. A., Clark A. W., Sternberger N. A., Sternberger L. A. Lewy body dementia without Alzheimer changes. Can J Neurol Sci. 1986 Nov;13(4 Suppl):490–497. doi: 10.1017/s0317167100037185. [DOI] [PubMed] [Google Scholar]
  71. Smits M. G., Gabreëls F. J., Thijssen H. O., 't Lam R. L., Notermans S. L., ter Haar B. G., Prick J. J. Progressive idiopathic strio-pallido-dentate calcinosis (Fahr's disease) with autosomal recessive inheritance. Report of three siblings. Eur Neurol. 1983;22(1):58–64. doi: 10.1159/000115537. [DOI] [PubMed] [Google Scholar]
  72. Takahashi K., Nakashima R., Takao T., Nakamura H. Pallido-nigro-luysial atrophy associated with degeneration of the centrum medianum. A clinicopathologic and electron microscopic study. Acta Neuropathol. 1977 Jan 31;37(1):81–85. doi: 10.1007/BF00684546. [DOI] [PubMed] [Google Scholar]
  73. Taylor A. E., Saint-Cyr J. A., Lang A. E. Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain. 1986 Oct;109(Pt 5):845–883. doi: 10.1093/brain/109.5.845. [DOI] [PubMed] [Google Scholar]
  74. Tennison M. B., Bouldin T. W., Whaley R. A. Mineralization of the basal ganglia detected by CT in Hallervorden-Spatz syndrome. Neurology. 1988 Jan;38(1):154–155. doi: 10.1212/wnl.38.1.154. [DOI] [PubMed] [Google Scholar]
  75. Ward C. D., Duvoisin R. C., Ince S. E., Nutt J. D., Eldridge R., Calne D. B. Parkinson's disease in 65 pairs of twins and in a set of quadruplets. Neurology. 1983 Jul;33(7):815–824. doi: 10.1212/wnl.33.7.815. [DOI] [PubMed] [Google Scholar]
  76. Yagishita S., Itoh Y., Nakano T., Amano N., Yokoi S., Hasegawa O., Tanaka T. Pleomorphic intra-neuronal polyglucosan bodies mainly restricted to the pallidium. A case report. Acta Neuropathol. 1983;62(1-2):159–163. doi: 10.1007/BF00684936. [DOI] [PubMed] [Google Scholar]
  77. Yamamura Y., Sobue I., Ando K., Iida M., Yanagi T. Paralysis agitans of early onset with marked diurnal fluctuation of symptoms. Neurology. 1973 Mar;23(3):239–244. doi: 10.1212/wnl.23.3.239. [DOI] [PubMed] [Google Scholar]
  78. Yokochi M., Narabayashi H., Iizuka R., Nagatsu T. Juvenile parkinsonism--some clinical, pharmacological, and neuropathological aspects. Adv Neurol. 1984;40:407–413. [PubMed] [Google Scholar]
  79. Yoshimura M. Cortical changes in the parkinsonian brain: a contribution to the delineation of "diffuse Lewy body disease". J Neurol. 1983;229(1):17–32. doi: 10.1007/BF00313493. [DOI] [PubMed] [Google Scholar]
  80. de León G. A. Bielschowsky bodies: Lafora-like inclusions associated with atrophy of the lateral pallidum. Acta Neuropathol. 1974;30(3):183–188. doi: 10.1007/BF00688919. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES