Progressive frontal gait disturbance with atypical Alzheimer’s disease and corticobasal degeneration
- aThe National Hospital for Neurology and Neurosurgery, Queen Square, London, UK, bMRC Cyclotron Unit, Hammersmith Hospital, 150 Du Cane Road, London, UK, cDepartment of Pathology, Institute of Psychiatry, De Crespigny Park, London, UK
- Professor M N Rossor, Dementia Research Group, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK. Telephone 0044 171 829 8773; fax 0044 171 209 0182.
- Received 7 August 1998
- Revised 14 December 1998
- Accepted 18 March 1999
Abstract
OBJECTIVES The clinical neuropsychological, neuroradiological, and neuropathological description of two patients presenting with a frontal gait disturbance.
METHODS Clinical case note review, neuropsychological assessment, functional imaging with 15O2 and 18F-fluorodopa PET, and neuropathology.
RESULTS Both patients presented with frontal gait impairment and only later developed more widespread cognitive impairment. In both cases15O2 PET disclosed focal hypometabolism in the medial frontal lobes and in one patient 18F-fluorodopa uptake into the caudate and putamen was normal. The neuropathological examination in one patient showed Alzheimer’s histopathology together with large swollen eosinophilic neurons characteristic of corticobasal degeneration, which were particularly prominent in the medial frontal lobes.
CONCLUSION Focal degeneration of the medial frontal lobes may present as an isolated gait disturbance and should be considered in the differential diagnosis of patients who present without an obvious structural abnormality on neuroimaging.
Footnotes
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↵* Deceased
