Hemiparkinsonism and levodopa-induced dyskinesias after focal nigral lesion.

We present a patient with tremor-dominant hemiparkinsonism after a focal lesion to the substantia nigra. An excellent response to levodopa was complicated by rapid development of motor fluctuations and disabling dyskinesias. Stereotactic thalamotomy resulted in a persistent extinction of parkinsonism and of dyskinesias along with stopping dopaminergic treatment. (c) 2005 Movement Disorder Society.