Photoclinic Diagnosis: Hallervorden-Spatz Disease

A25-year-old male was admitted for involuntary contractions of hands (which was prominent in the left hand) and difficulties in articulation, swallowing, and facial grimacing (pouting). His problems had started at the age of 16, with involuntary contraction of the left index finger. About 7 to 8 months later, involuntary contraction of the left 3rd finger occurred, and then all fingers of the left hand showed the same feature and finally, the right hand was affected. In the last 10 years, dysarthria and dysphagia have developed leading to occupational incapacity of the patient as a farmer. He was the first case in the pedigree and the parents were not close relatives. His past personal or family history was not remarkable.