Neurology: Case of the Month

Test Yourself — Patient 17

Corticobasal Ganglionic Degeneration (CBGD)

  1. The following statement is TRUE regarding CBGD:
    • [ A ] The mean survival is 10 to 15 years.
    • [ B ] The most common signs associated with CBGD are limb rigidity and apraxia.
    • [ C ] Symptoms most often begin in the legs with difficulty in walking.
    • [ D ] Tremor, frontal lobe reflexes, and cognitive impairment are almost always present.
  2. The following statement concerning apraxia is correct:
    • [ A ] Ideomotor apraxia is associated with dysfunction of the right parietal lobe.
    • [ B ] If you are right handed, the engram for movement sequences of the left hand is most likely in the right hemisphere.
    • [ C ] Buccofacial apraxia is more commonly seen than ideomotor apraxia in patients with CBGD.
    • [ D ] In ideational apraxia, the concept behind a skilled movement is lost and subjects do not improve when given the object.
  3. All of the following pathological findings are commonly seen in CBGD EXCEPT:
    • [ A ] Senile plaques and neurofibrillary tangles in cortical basal regions
    • [ B ] Swollen neuronal bodies with eccentric displacement of the nucleus and lack of cytoplasmic staining
    • [ C ] Neuronal loss in outer layers of the cortical areas of the frontal and parietal lobes
    • [ D ] Loss of neurons in the substantia nigra, subthalamic nucleus, and dentate nuclei
  4. All of the following eye findings are associated with CBGD EXCEPT:
    • [ A ] Slow saccadic pursuit
    • [ B ] Supranuclear gaze paresis
    • [ C ] Prolonged latency in initiating saccades
    • [ D ] Dysconjugate eye movements
  5. The following statement is TRUE regarding CBGD:
    • [ A ] Patients usually show marked improvement in symptoms within one to two months following treatment with carbidopa/levodopa.
    • [ B ] The alien hand syndrome occurs in 55% of patients and helps in differentiating the disease from other neurodegenerative disorders.
    • [ C ] The atrophy seen on CT or MRI will be asymmetric corresponding to the symptomatic side.
    • [ D ] Deep tendon reflexes would be normal in patients with CBGD.

 

Email comments: