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Corticobasal syndrome — SCE Neurology MCQ

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ModerateMovement DisordersCorticobasal syndromeSCE Neurology

A 31-year-old woman presented with asymmetric limb rigidity with apraxia and an alien limb phenomenon. On examination, there was cortical sensory loss and stimulus-sensitive myoclonus. Initial investigations showed: MRI showed asymmetric frontoparietal atrophy. What is the most likely diagnosis?

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Correct answer: D — Corticobasal syndrome

Corticobasal syndrome is the best answer because the vignette describes Corticobasal syndrome: cortical signs with asymmetric rigid limb indicate corticobasal syndrome. Multiple system atrophy is plausible in a neighbouring presentation, but the chronology, examination or investigation pattern does not match the key discriminator here. Levodopa-induced dyskinesia and Huntington's disease are less appropriate because they would require different localisation, timing or test findings; Functional tremor would fit a different syndrome. Clinical pearl: MND would not cause apraxia or alien limb.

Reference: NICE NG71; Movement Disorder Society consensus criteria