Adult polyglucosan body disease associated with an extrapyramidal syndrome
- aUniversity of Cambridge Neurology Unit, bDepartment of Neuropathology, Addenbrooke’s Hospital, Hills Road, Cambridge, UK
- Dr N Robertson, University of Cambridge, Neurology Unit, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK. Telephone 0044 1223 216751; fax 0044 1223 336941.
- Received 5 February 1998
- Revised 7 May 1998
- Accepted 15 May 1998
Abstract
A 50 year old patient is described who presented with parkinsonism, frontal dementia, peripheral neuropathy, neurogenic bladder, and upper motor neuron signs. No improvement in objective measurements of extrapyramidal dysfunction were seen with an incremental apomorphine test or more prolonged oral dopamine challenge. Neurophysiology disclosed changes compatible with a diffuse axonal neuropathy and pathological examination of a length of sural nerve taken at biopsy showed multiple polyglucosan bodies characteristic of adult polyglucosan body disease (APGBD). This case underlines the diverse clinical presentation of this rare neurological disease and the importance of recognising the unusual association of clinical features in making the diagnosis. APGBD should be included in the differential diagnosis of parkinsonism unresponsive to dopaminergic therapy.
