Corticobasal syndrome with visual hallucinations and probable REM-sleep behavior disorder: an autopsied case report of a patient with CBD and LBD pathology

Neurocase. 2019 Feb-Apr;25(1-2):26-33. doi: 10.1080/13554794.2019.1604973. Epub 2019 Apr 22.

Abstract

Corticobasal syndrome and dementia with Lewy bodies are clinical presentations with unique and overlapping features but distinct pathological substrates. We report the case of an 80 year-old man who presented with apraxia, rigidity, slowness, right arm myoclonus, a 10-year history of probable REM-sleep behavior disorder, and later developed visual hallucinations. At autopsy, he had pathological features of corticobasal degeneration, and Lewy body disease confined to the brainstem. This report highlights the importance of considering co-existing pathologies when a clinical presentation defies categorization, and demonstrates that salient features of dementia with Lewy bodies may result from pathology limited to the brainstem.

Keywords: Corticobasal syndrome; corticobasal degeneration; dementia with Lewy body disease; pathology; tau; α-synuclein.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Autopsy
  • Basal Ganglia Diseases / complications
  • Basal Ganglia Diseases / diagnosis*
  • Basal Ganglia Diseases / pathology
  • Basal Ganglia Diseases / physiopathology
  • Hallucinations / etiology
  • Hallucinations / physiopathology
  • Humans
  • Lewy Body Disease / complications
  • Lewy Body Disease / diagnosis
  • Lewy Body Disease / pathology
  • Lewy Body Disease / physiopathology
  • Male
  • Neurodegenerative Diseases / complications
  • Neurodegenerative Diseases / diagnosis*
  • Neurodegenerative Diseases / pathology
  • Neurodegenerative Diseases / physiopathology
  • REM Sleep Behavior Disorder / etiology
  • REM Sleep Behavior Disorder / physiopathology