title: Progressive supranuclear gaze palsy without parkinsonism: a case of neuro-Whipple.
abstract: We report the case of a 69-year-old man with a 7-month history of severe progressive supranuclear gaze palsy associated with mild cognitive decline and sleep disturbances, but not parkinsonism. After a period spent consulting a range of different specialists, the appearance of brachial myoclonus prompted his referral to a movement disorders specialist. Duodenum biopsy confirmed the suspicion of neuro-Whipple disease. Antibiotic therapy was started but the delay in the diagnosis proved fatal to this patient. This noteworthy case shows unusual neurological features of a rare but treatable disease, often misdiagnosed as progressive supranuclear palsy.
authors.affiliation: Neurological Clinic, University Hospital, University of Modena and Reggio Emilia, Via Del Pozzo no 71, 41100, Modena, Italy. maganna@unimore.it
authors.forename: Anna
authors.initials: A
authors.lastname: Magherini
authors.forename: Roberta
authors.initials: R
authors.lastname: Pentore
authors.forename: Marco
authors.initials: M
authors.lastname: Grandi
authors.forename: Maria E
authors.initials: ME
authors.lastname: Leone
authors.forename: Paolo F
authors.initials: PF
authors.lastname: Nichelli
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000209:etiology*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010300:Parkinson Disease / Q000175:diagnosis; D012893:Sleep Wake Disorders / Q000209:etiology; D013494:Supranuclear Palsy, Progressive / Q000150:complications* / Q000473:pathology*