Abstract
Two years ago a 64-year-old man presented at a specialist clinic with unilateral tremor in the right hand His past medical history was unremarkable. An initial diagnosis of tremulous Parkinson's disease (PD) was made, but dopaminergic treatment was unsuccessful. A ioflupane (123I) single positron emission tomography scan (DaTSCAN) showed a normal representation in the right striatum; conversely, ligand binding was absent in the left caudate and markedly reduced in the left putamen (Fig. 1A). This gentleman was recently seen for the first time at my centre; on examination, there was postural and kinetic tremor in the right hand, accompanied by mild rigidity but no bradykinesia.
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