Corticobasal syndrome (CBS) is a clinical entity characterised by asymmetric extrapyramidal features, cortical signs and focal cortical atrophy. Although CBS is classically described as a tauopathy, recent reports demonstrate considerable pathologic heterogeneity in patients with clinical profile of CBS. We report a patient with posterior thalamic tuberculoma who developed clinical features of CBS as the lesion resolved. Sequential MRI revealed progressive atrophy of the ipsilateral parietotemporal cortex. Hypometabolism of the posterior thalamus and the involved parietotemporal cortex was demonstrated on 18-FDG PET, while diffusion tensor imaging revealed degeneration of the superior and posterior thalamic radiations. We propose that the focal cortical atrophy in this case is secondary to destruction of thalamic nuclei, Wallerian degeneration of the thalamocortical radiations and subsequent trans-synaptic neuronal degeneration. Our case further extends the etiological spectrum of clinical presentation of CBS.
- corticobasal syndrome
- focal cortical atrophy
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