title: Discrepancy between clinical and pathological diagnoses of CBD and PSP.
abstract: Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are often clinically confused with each other. Moreover, the discrepancy between clinical and pathological diagnoses of CBD and PSP are still controversial. We report here two atypical cases of PSP and CBD. A 73-year old woman was admitted with right hand rigidity, limb kinetic apraxia and cortical sensory loss. Brain atrophy, hypoperfusion and hypometabolism predominantly in the left frontoparietal lobes indicated CBD clinically. Pathological studies revealed neuronal loss and spongy change without ballooned neurons (BN) in the cerebral cortex. Modified Gallyas-Braak (G-B) staining revealed neurofibrillary tangles (NFTs) and tufted astrocytes, indicating pathological diagnosis of PSP. A 75-year-old man admitted with vertical gaze palsy, neck dystonia, parkinsonism and dementia. Atrophy of the frontal lobes and tegmentum of the midbrain and symmetrical frontal hypoperfusion in SPECT indicated PSP. However, neuronal loss and BN in the frontal lobes and clusters of astrocytic plaques indicated CBD pathologically. The G-B staining was useful for differentiating between CBD and PSP, but our atypical cases bring up a new issue about differential diagnosis of CBD and PSP.
authors.affiliation: Kyoto Prefectural University of Medicine, Dept. of Neurology, Kajiicho-465, Kamigyo-ku, 602-8566 Kyoto, Japan. mizuno@koto.kpu-m.ac.jp
authors.forename: Toshiki
authors.initials: T
authors.lastname: Mizuno
authors.forename: Kensuke
authors.initials: K
authors.lastname: Shiga
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Nakata
authors.forename: Junko
authors.initials: J
authors.lastname: Nagura
authors.forename: Taizen
authors.initials: T
authors.lastname: Nakase
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ueda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Takanashi
authors.forename: Kohji
authors.initials: K
authors.lastname: Urasaki
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Oyamada
authors.forename: Shinji
authors.initials: S
authors.lastname: Fushiki
authors.forename: Junji
authors.initials: J
authors.lastname: Nishikawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yasuhara
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakajima
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D000368:Aged; D001479:Basal Ganglia / Q000473:pathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019636:Neurodegenerative Diseases / Q000175:diagnosis* / Q000503:physiopathology; D016874:Neurofibrillary Tangles / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis* / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods