CORTICOBASAL SYNDROME PRESENTING AS A PROGRESSIVE HEMIPARETIC SYNDROME: A CASE REPORT.
11Stroke Unit, Division of Neurosciences, University Hospital Center 'Mother Teresa', Tirana, Albania.
Georgian Medical News
|January 9, 2026
Summary
Corticobasal syndrome (CBS) presents diagnostic challenges due to overlapping symptoms with other neurodegenerative diseases. This case highlights the importance of clinical asymmetry and DaT-SPECT imaging in diagnosing CBS, especially in resource-limited settings.
Area of Science:
- Neuroscience
- Neurology
- Geriatrics
Background:
- Corticobasal syndrome (CBS) is a rare, heterogeneous neurodegenerative disorder often linked to corticobasal degeneration (CBD).
- CBS diagnosis is complicated by overlapping phenotypes with conditions like Alzheimer's disease (AD), progressive supranuclear palsy (PSP), and frontotemporal lobar degeneration (FTLD).
- Clinicopathologic concordance in CBS is imperfect, posing diagnostic challenges.
Purpose of the Study:
- To present a challenging case of Corticobasal Syndrome (CBS).
- To highlight the diagnostic utility of clinical asymmetry and dopamine transporter (DaT) SPECT imaging in CBS.
- To underscore the difficulties in diagnosing CBS, particularly in resource-limited environments.
Main Methods:
- Case report of a 55-year-old woman with a four-year history of progressive right-sided spastic hemiparesis and rigidity.
- Electroneuromyography (ENMG) showed isolated upper motor neuron (UMN) findings.
- Brain MRI revealed perirolandic cortical atrophy; DaT-SPECT demonstrated a unilateral presynaptic dopaminergic deficit.
Main Results:
- The patient presented with marked clinical asymmetry and parkinsonism.
- DaT-SPECT imaging revealed a significant unilateral presynaptic dopaminergic deficit.
- Levodopa challenge test was ineffective, and no sensory, cerebellar, or autonomic features were observed.
Conclusions:
- Marked clinical asymmetry and dopaminergic deficit strongly support a diagnosis of CBS.
- Corticobasal degeneration (CBD) is the most probable underlying pathology, though differential diagnoses include PSP, AD, and MSA.
- This case emphasizes the diagnostic complexity of CBS and the value of multimodal imaging, especially DaT-SPECT, in differentiating it from other neurodegenerative syndromes, particularly when advanced imaging is unavailable.
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