A case of late onset striatonigral degeneration

We report the case of a 78-year-old patient who had a parkinsonian syndrome which did not respond to levodopa treatment. The duration of the illness was four years. The main clinical features were bradykinesia and rigidity. He also showed pseudobulbar and pyramidal syndromes. The prominent pathological findings were a severe neuronal loss in the depigmented substantia nigra and in the putamen, which showed a brownish discoloration. Although the late age of onset is unusual, the findings suggest striatonigral degeneration. The link of this disease to multiple system atrophy is discussed.