Left-sided hemihypomimia in Parkinson's disease

Parkinson's disease is known to present and mostly persist as an asymmetrical movement disorder in most cases. The asymmetry is mainly described in motor features such as bradykinesia, rigidity and tremor in upper and lower limbs. Unilateral hypomimia however, has only been reported in 14 patients, all of whom showed right-sided hemihypomimia. In this case report we describe the symptoms of a 51-year-old man with predominant left-sided Parkinson's disease in whom we discovered a left-sided hemihypomimia. We also briefly review the literature concerning hemihypomimia in Parkinson's disease. We conclude that a larger case series needs to be studied to further elucidate the pathophysiology and clinical implications of this observation.