Stroke of the substance nigra and parkinsonism as first manifestation of systemic lupus erythematosus.

The authors report one case of parkinsonism associated with systemic lupus erythematosus (SLE): a 45-year-old woman, who presented with a strategic infarct of the right substance nigra secondary to vasculitis, and contralateral symptoms. Other causes of parkinsonism were excluded. She had a partial response to therapy with levodopa. Parkinsonism as the first manifestation of lupus is extremely rare. This is the first reported case with strategic infarction in the substance nigra secondary to vasculitis in a patient with SLE.