title: Precipitous Deterioration of Motor Function, Cognition, and Behavior.
abstract: A 72-year-old woman developed new-onset depression, sustained an unexplained fall, and started walking cautiously. After 1 year, her depression resolved but she developed a dry cough. One year later, she experienced a more rapid decline in her gait with parkinsonism, visual difficulties with restricted vertical gaze, slowed horizontal and vertical saccades, dysphagia, apathy, and progressive cognitive decline, which led to her death 2 years later. The differential diagnosis, neuroimaging, and pathological findings are discussed, as well as their public health implications.
authors.affiliation: Department of Neurology, La Paz University Hospital, Madrid, Spain2Memory and Aging Center, University of California, San Francisco, San Francisco.
authors.forename: Mireya
authors.initials: M
authors.lastname: Fernández-Fournier
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco.
authors.forename: David C
authors.initials: DC
authors.lastname: Perry
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco3Department of Neurology, Tanz Centre, University of Toronto, Toronto, Canada.
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Tartaglia
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco.
authors.forename: Mary
authors.initials: M
authors.lastname: de May
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco.
authors.forename: Adam
authors.initials: A
authors.lastname: Boxer
authors.affiliation: Departments of Psychiatry & Biobehavioral Sciences and Neurology, University of California, Los Angeles.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Coppola
authors.affiliation: Department of Neurology, Division of Movement Disorders, University of California, San Francisco, San Francisco.
authors.forename: Chadwick W
authors.initials: CW
authors.lastname: Christine
authors.affiliation: Department of Pathology, University of California San Francisco and Pathology Service, Veterans Affairs Medical Center, San Francisco.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Huang
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco7Department of Pathology, University of California San Francisco, San Francisco.
authors.forename: William W
authors.initials: WW
authors.lastname: Seeley
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.affiliation: Department of Pathology, University of California San Francisco, San Francisco.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: DeArmond
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco7Department of Pathology, University of California San Francisco, San Francisco.
authors.forename: Lea T
authors.initials: LT
authors.lastname: Grinberg
authors.affiliation: Memory and Aging Center, University of California, San Francisco, San Francisco.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Geschwind
mesh_terms: D000368:Aged; D007562:Creutzfeldt-Jakob Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D000072002:Prion Proteins / Q000032:analysis*
chemical_list: D000072002:Prion Proteins