Spastic Paraplegia Accompanied by Extrapyramidal Sign and Frontal Cognitive Dysfunction

Area of Science:

• Neurology
• Neuroimaging
• Neurodegeneration

Background:

• Spastic paraplegia is a complex neurodegenerative disorder characterized by progressive spasticity in the lower limbs.
• Clinical presentations can vary, necessitating further investigation into atypical forms.

Observation:

• The presented case exhibited spastic paralysis and hyperreflexia across all extremities.
• Lead pipe rigidity was noted in the neck and bilateral upper extremities (more pronounced on the right).
• Cognitive assessment revealed decreased scores on frontal tests.

Findings:

• A DaTscan indicated reduced dopamine transporter accumulation in the right dorsal putamen.
• 99mTc-ECD SPECT imaging showed hypoperfusion in the bilateral frontal lobes.
• These findings correlate clinical symptoms with neuroimaging abnormalities.

Implications:

• This case broadens the spectrum of spastic paraplegia presentations.
• It highlights the utility of integrated clinical and advanced neuroimaging for diagnosing complex neurological disorders.
• Further research may elucidate the specific mechanisms underlying this complicated spastic paraplegia variant.