title: Epileptic seizure as a precipitating factor of vascular progressive supranuclear palsy: a case report.
abstract: BACKGROUND
  Vascular progressive supranuclear palsy (vPSP) is an uncommon akinetic-rigid syndrome characterized by asymmetric lower body involvement, predominant corticospinal and pseudobulbar signs, urinary incontinence, cognitive impairment, and increased frequency of stroke risk factors, together with neuroimaging evidence of vascular disease.
  
  
  METHODS
  We report a case of a patient with a PSP-like phenotype and marked cognitive impairment who significantly worsened after a generalized epileptic seizure that occurred a few months after its clinical onset.
  
  
  RESULTS
  Signs of widespread ischemic subcortical vascular disease, together with atrophy of the midbrain tectum, corpus callosum, and cerebral cortex, were evident on brain magnetic resonance imaging.
  
  
  CONCLUSIONS
  vPSP is a condition that should be considered when a patient presents with a gradually progressive clinical picture suggestive of idiopathic PSP associated with neuroimaging evidence of cerebrovascular disease. The occurrence of epileptic seizures has not been reported before in vPSP but they might trigger the onset or precipitate the course of the PSP-like disorders.
authors.affiliation: Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina (EN), Italy. Electronic address: giuseppelanza2003@yahoo.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lanza
authors.affiliation: Department of Neurorehabilitation, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina (EN), Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Papotto
authors.affiliation: Department of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pennisi
authors.affiliation: Department of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Bella
authors.affiliation: Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina (EN), Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D003071:Cognition; D018450:Disease Progression; D004827:Epilepsy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010641:Phenotype; D012307:Risk Factors; D013494:Supranuclear Palsy, Progressive / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000978:Antiparkinson Agents
keywords: Leukoaraiosis; cognitive impairment; epilepsy; neuroimaging; parkinsonism