Hemibody mirror movements in hemiparkinsonism-hemiatrophy syndrome

Hemiparkinsonism-hemiatrophy syndrome (HPHA) is a relatively rare cause of secondary parkinsonism. Mirror movements (MM) are associated with a variety of congenital and acquired conditions, including some forms of parkinsonism. This report describes a patient with the HPHA phenotype who exhibited MM, a feature that has not been previously reported in this syndrome. Surface electromyography (EMG) was used to illustrate the virtually simultaneous occurrence of voluntary and involuntary movements. Needle EMG was used to diagnose a spinal accessory neuropathy. Pathological mirroring or overflow movement of the orbicularis oculi muscle is also hypothesized. The clinical features are demonstrated on video.