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Corticobasal Degeneration — SCE Neurology MCQ

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HardMovement DisordersCorticobasal DegenerationSCE Neurology

A 55-year-old man presents with progressive asymmetric rigidity, dystonia, and apraxia of the left hand. He reports his left hand sometimes moves involuntarily and feels "alien" to him. MRI brain shows asymmetric right frontoparietal cortical atrophy. What is the most likely diagnosis?

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Correct answer: E — Corticobasal degeneration

The best answer is “Corticobasal degeneration”. Parkinsonian syndromes are distinguished by tempo, symmetry, eye movements, falls, autonomic and cognitive features; treatment is individualised to motor and neuropsychiatric burden. The alternatives “Parkinson's disease”, “Progressive supranuclear palsy”, “Multiple system atrophy”, “Frontotemporal dementia” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG71 Parkinson disease recommendations: https://www.nice.org.uk/guidance/ng71/chapter/Recommendations