Anomalies of asymmetry of clinical signs in XXXX .

@entity1 @entity2003 @entity304 @entity191 @entity2845 @entity400
@entity191 ( @entity191 ) is characterized by a minimum of two of three features: @entity400 , @entity2003 , and @entity2845 . Asymmetry of these features is often considered to support a diagnosis of @entity191 in contrast to other @entity191 . All major manifestations of @entity191 are often more pronounced on the side first manifesting features of @entity191 . Significant dissociation of features on the contralateral side, along with other variants of presentation involving the contralateral side, are rarely observed. To determine the frequency and significance of unusual asymmetry in @entity304 , we retrospectively examined 613 @entity1 clinically diagnosed as idiopathic @entity191 for presence of unusual asymmetries of clinical features. Three groups of @entity1 with unusual asymmetrical clinical findings were identified. Group 1 comprised 10 @entity1 followed for an average of 6 years presenting with rest @entity400 most prominent in one lower limb and contralateral upper limb. Group 2 comprised 24 @entity1 followed for an average of 5.5 years with action @entity400 most prominent on the side contralateral to the side of most prominent rest @entity400 . Group 3 comprised 33 @entity1 followed for an average of 10 years who had @entity191 signs of greatest severity on one side but subsequently, over an average of 5.4 years, became gradually more prominent on the opposite side. In Group 3, 15 of 33 @entity1 (45%) demonstrated evolution to a rigid form of @entity304 with disappearance of rest @entity400 over an average of 7.1 years after presentation. A small percentage (11%) of @entity191 @entity1 in our clinic demonstrated anomalous asymmetrical clinical findings, which indicates that (1) the disease process may begin in different topographic sites on each side; (2) rest @entity400 and action @entity400 may have different anatomical bases; (3) the disease process may progress at different rates on different sides; and (4) @entity400 becomes less pronounced with progression of disease in some @entity1 with @entity304 .
