{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:27:57Z","timestamp":1761006477324,"version":"build-2065373602"},"reference-count":3,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,7]],"date-time":"2017-12-07T00:00:00Z","timestamp":1512604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2018,1]]},"abstract":"Abstract<\/jats:title>View Supplementary Video 1<\/jats:ext-link><\/jats:p><\/jats:sec>A 33 year\u2010old male presented with right upper limb rest tremor that disappeared on action, posture associated with bradykinesia, and rigidity of right upper and lower limbs (Video ). Patient also presented right\u2010sided pyramidal weakness (grade 4), hyperreflexia, extensor plantar response, and hemihypesthesia. Skull X\u2010ray and computed tomography (CT<\/jats:styled-content>) of the brain showed several metal pellets producing multiple artifacts (Fig. A,B). Only one pellet settled in brain parenchyma (left midbrain), while other pellets settled in the skull bone (Fig. A). Transcranial sonography (TCS<\/jats:styled-content>) was performed, confirming that the midbrain pellet was placed within the left substantia nigra (Fig. C). Levodopa challenge test was conducted, showing no improvement (pre\u2010 and post\u2010l\u2010dopa motor UPDRS<\/jats:styled-content> were 21 and 20, respectively). A further chronic trial of l\u2010dopa (for 3 months) also proved negative. Biperiden and propranolol were also tried with negative results.<\/jats:p>Computed tomography (CT<\/jats:styled-content>) of the brain and X\u2010ray skull showed several pellets that produced multiple streak artifacts (Fig. A,B). Only one pellet rested in the brain parenchyma, the left (contralateral) midbrain as detected by CT<\/jats:styled-content> (Fig. A), and transcranial sonography (Esaote MyLab Five, Providian, Italy) via temporal window (Fig. C). Abbreviations: SN, substantia nigra.<\/jats:p><\/jats:caption>image<\/jats:alt-text><\/jats:graphic><\/jats:fig>Hemiparkinsonism has been previously reported secondary to midbrain lesions. To the best of our knowledge, movement disorders (secondary to brain injuries) related to bullet fragments have been scantly reported. In one reported case, hemiparkinsonism and dystonia were the result of a bullet in midbrain, and in another, dystonia was caused by a bullet in internal capsule.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.12566","type":"journal-article","created":{"date-parts":[[2017,11,2]],"date-time":"2017-11-02T11:21:38Z","timestamp":1509621698000},"page":"103-104","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patient with Hemiparkinsonism Secondary to a Gun Pellet in the Contralateral Substantia Nigra"],"prefix":"10.1002","volume":"5","author":[{"given":"Ali","family":"Shalash","sequence":"first","affiliation":[{"name":"Department of Neurology Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eman","family":"Abushady","sequence":"additional","affiliation":[{"name":"Department of Neurology Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eman","family":"Hamid","sequence":"additional","affiliation":[{"name":"Department of Neurology Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Salama","sequence":"additional","affiliation":[{"name":"Medical Experimental Research Center (MERC) Faculty of Medicine Mansoura University Mansoura Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosra Abdelzaher","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Radiology Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,12,7]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20453"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.5.658"},{"issue":"3","key":"e_1_2_4_4_1","first-page":"98","article-title":"Dystonic hand associated with spontaneous migration of a retained bullet","volume":"3","author":"Polemikos M","year":"2015","journal-title":"Mov Disord Clin Pract"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmdc3.12566","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.12566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:13:04Z","timestamp":1760951584000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.12566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,7]]},"references-count":3,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1002\/mdc3.12566"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.12566","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"type":"print","value":"2330-1619"},{"type":"electronic","value":"2330-1619"}],"subject":[],"published":{"date-parts":[[2017,12,7]]},"assertion":[{"value":"2017-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-10-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}