(A-C) Macroscopic and microscopic features of our patient's brain (post-mortem). (A) Left: hemi-midbrain showing pallor of the substantia nigra (between arrows); right: control midbrain showing normal pigmentation. (B) Severe neuronal loss, microvacuolation, and gliosis in the substantia nigra of affected hemi-midbrain. Macrophages containing neuromelanin pigment (arrows). (C) Numerous glial cytoplasmic inclusions in the internal capsule. Stain types: (B), hematoxylin and eosin; (C), α-synuclein immunohistochemistry. Bars: 100 μm.