Progressive supranuclear palsy diagnosis and confounding features: Report on 16 autopsied cases
Identifieur interne : 004321 ( Main/Exploration ); précédent : 004320; suivant : 004322Progressive supranuclear palsy diagnosis and confounding features: Report on 16 autopsied cases
Auteurs : Sam Birdi [Canada] ; Ali H. Rajput [Canada] ; Mark Fenton [Canada] ; Jeffery R. Donat [Canada] ; Bohdan Rozdilsky [Canada] ; Christopher Robinson [Canada] ; Rob Macaulay [Canada] ; David George [Canada]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-11.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Autopsy, Brain (pathology), Diagnosis, Diagnosis, Differential, Dopamine Agonists (therapeutic use), Drug Therapy, Combination, Female, Human, Humans, Levodopa, Levodopa (therapeutic use), Magnetic Resonance Imaging, Male, Middle Aged, Neurologic Examination (drug effects), Prognosis, Progressive, Supranuclear Palsy, Progressive (diagnosis), Supranuclear Palsy, Progressive (drug therapy), Supranuclear Palsy, Progressive (pathology), Supranuclear ophthalmoplegia, Symptomatology, Treatment Outcome, diagnosis, levodopa treatment, prognosis, progressive supranuclear palsy.
- MESH :
- chemical , therapeutic use : Dopamine Agonists, Levodopa.
- diagnosis : Supranuclear Palsy, Progressive.
- drug effects : Neurologic Examination.
- drug therapy : Supranuclear Palsy, Progressive.
- pathology : Brain, Supranuclear Palsy, Progressive.
- Aged, Aged, 80 and over, Diagnosis, Differential, Drug Therapy, Combination, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prognosis, Treatment Outcome.
Abstract
We evaluated 16 (15 men, 1 woman) autopsy‐verified progressive supranuclear palsy (PSP) cases during 31 years (1969–2000) for clinical diagnosis and the course of the disease. The onset was gait difficulty or postural instability in 9 (56.3%), general motor slowing in 3 (18.8%), and tremor in 2. One case had onset with cognitive decline and 1 as hemidystonia. Four cases had supranuclear ophthalmoplegia (SNO) at the first assessment and were diagnosed as PSP. By last assessment, PSP diagnosis was made in 4 additional cases, but in 8 (50%) who never manifested ophthalmoplegia (mean 9.8 years after onset), PSP diagnosis was not made. Other manifestations included bulbar symptoms in 13 (81.3%), and cognitive impairment in 10 (62.5%) during the course of illness. Fifteen cases received levodopa, amantadine, anticholinergics, dopamine agonists, and selegiline in different combinations with symptomatic benefit in 9 of 15 (60%). Five had some improvement on levodopa alone and 3 showed more improvement when a dopamine agonist was added to levodopa. In general, the benefit was minimal and occurred only early in the course of illness. The mean age at onset was 63.7 (range, 53–85) years. Mean duration at PSP diagnosis was 4.8 (range, 2–11) years. Mean survival was 8.6 (range, 3–24) years and mean age at death was 72.3 (range, 60–89) years. When the different diagnostic criteria recommended in the literature were used, the accuracy of clinical diagnosis did not improve substantially. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10211
Affiliations:
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Le document en format XML
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<term>Diagnosis, Differential</term>
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<front><div type="abstract" xml:lang="en">We evaluated 16 (15 men, 1 woman) autopsy‐verified progressive supranuclear palsy (PSP) cases during 31 years (1969–2000) for clinical diagnosis and the course of the disease. The onset was gait difficulty or postural instability in 9 (56.3%), general motor slowing in 3 (18.8%), and tremor in 2. One case had onset with cognitive decline and 1 as hemidystonia. Four cases had supranuclear ophthalmoplegia (SNO) at the first assessment and were diagnosed as PSP. By last assessment, PSP diagnosis was made in 4 additional cases, but in 8 (50%) who never manifested ophthalmoplegia (mean 9.8 years after onset), PSP diagnosis was not made. Other manifestations included bulbar symptoms in 13 (81.3%), and cognitive impairment in 10 (62.5%) during the course of illness. Fifteen cases received levodopa, amantadine, anticholinergics, dopamine agonists, and selegiline in different combinations with symptomatic benefit in 9 of 15 (60%). Five had some improvement on levodopa alone and 3 showed more improvement when a dopamine agonist was added to levodopa. In general, the benefit was minimal and occurred only early in the course of illness. The mean age at onset was 63.7 (range, 53–85) years. Mean duration at PSP diagnosis was 4.8 (range, 2–11) years. Mean survival was 8.6 (range, 3–24) years and mean age at death was 72.3 (range, 60–89) years. When the different diagnostic criteria recommended in the literature were used, the accuracy of clinical diagnosis did not improve substantially. © 2002 Movement Disorder Society</div>
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