Volume 7 ; Issue 1 ; in Month : Jan-June (2026) Article No : 114
Sanjiv Chamraj and Sharan Srinivasan

Abstract

Hemiparkinsonism, characterized by tremor, rigidity, and bradykinesia affecting one side of the body, can occur as a secondary, often subacute, symptom of demyelinating diseases like multiple sclerosis or osmotic demyelination syndrome. We reported a very rare case of right hemiparkinsonism due to demyelination disorder in a 47-year-old female from south India. A 47-year-old female presented with a history of hemiparkinsonism characterized by imbalance while walking. She was having normal blood pressure and blood sugar levels. She was doing well and able to do her activities of daily living. CSF for oligoclonal band revealed type 2 band pattern oligoclonal bands seen only in CSF, while no bands were seen in serum indicating intrathecal IgG synthesis. However, tests for anti-aquaporin-4 (NMO) IgG antibodies and Anti-MOG IgG antibodies showed negative. Her contrast MRI brain scan suggestive of multiple chronic cerebral and brainstem demyelinating plaques. Additionally, the left frontoparietal and right parietal periventricular lesions with paramagnetic rim signs indicate chronic active (smouldering) lesions. Furthermore, abnormal VEP showed bilateral optic nerve demyelination. The patient condition of right sided hemiparkinsonism secondary to demyelinating disorders improved on treatment with neuro anti-inflammatory drugs. Inconclusion, to the best of our literature this is the very rare case of right sided hemiparkinsonism secondary to demyelination disorders presented with clinical manifestations of imbalance while walking in a 47-year-old female from south India.

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