Monomelic parkinsonian tremor caused by contralateral substantia nigra stroke.

Patients with Parkinson's disease have been frequently classified by their most prominent symptoms into tremor-predominant and akinetic/rigid variants. A few pathological studies have suggested that these different phenotypes represent topographical differences in nigral pathology. A patient is described in whom a medial substantia nigra stroke led to contralateral lower extremity parkinsonian tremor, providing a clinical-pathological correlation of this tremor, indicating a somatotopic organization of the substantia nigra and supporting the central generator hypothesis of parkinsonian tremor.