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Clinical Imaging Correlation

Hen Hallevi, MD; Irene J. Oh, MD; Sherley R. Valdez, MD; Benjamin G. Kidder, MD; Mya C. Schiess, MD

Arch Neurol. 2008;65(6):837.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 56-year-old woman presented with a 1-year history of nonprogressive gait disturbance. On examination she had marked parkinsonian features limited to the right side. Her symptoms started after a flulike illness that lasted 2 months and had manifested with sore throat, fever, severe fatigue, and sleepiness. Findings from her workup revealed a high titer of anti–Epstein-Barr virus IgG antibodies and a left substantia nigra lesion on her magnetic resonance imaging scan (Figure). The cerebrospinal fluid content was unremarkable. Findings from antistreptolysin O titer, West Nile serology, and cerebrospinal fluid oligoclonal bands testing were negative. The lesion seen on magnetic resonance imaging correlates with the clinical symptoms and likely represents a subtle postencephalitic scarring of the substantia nigra. Unlike previously published images,¹ this finding is subtle and it may be . . . [Full Text of this Article]

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