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Corticobasal syndrome — SCE Neurology MCQ

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HardMovement DisordersCorticobasal syndromeSCE Neurology

A 67-year-old woman has progressive left-hand clumsiness and stiffness. She describes the hand as acting independently. Examination shows asymmetric rigidity, cortical sensory loss, limb apraxia and stimulus-sensitive myoclonus. MRI shows asymmetric right frontoparietal atrophy. Where is the most likely anatomical localisation?

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Correct answer: A — Right frontoparietal cortex and basal ganglia

Right frontoparietal cortex and basal ganglia is the best answer. Alien limb, apraxia, cortical sensory loss and asymmetric frontoparietal atrophy localise to contralateral frontoparietal cortex with basal ganglia involvement. Occipital disease gives visual symptoms; cerebellar disease causes ataxia; ulnar neuropathy is peripheral; anterior horn cell disease lacks cortical signs. Clinical pearl: Corticobasal syndrome is a clinical syndrome with cortical and extrapyramidal features.

Reference: Movement Disorder Society atypical parkinsonism criteria