Progressive supranuclear gaze palsy without parkinsonism: a case of neuro-Whipple
Anna Magherini1, Roberta Pentore, Marco Grandi
1Neurological Clinic, University Hospital, University of Modena and Reggio Emilia, Via Del Pozzo no 71, 41100, Modena, Italy. maganna@unimore.it
Abstract:
We report the case of a 69-year-old man with a 7-month history of severe progressive supranuclear gaze palsy associated with mild cognitive decline and sleep disturbances, but not parkinsonism. After a period spent consulting a range of different specialists, the appearance of brachial myoclonus prompted his referral to a movement disorders specialist. Duodenum biopsy confirmed the suspicion of neuro-Whipple disease. Antibiotic therapy was started but the delay in the diagnosis proved fatal to this patient. This noteworthy case shows unusual neurological features of a rare but treatable disease, often misdiagnosed as progressive supranuclear palsy.
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