Cortical Basal Ganglionic Degeneration Follow-up

  • Author: Anna M Barrett, MD; Chief Editor: Selim R Benbadis, MD   more...
 
Updated: Feb 19, 2010
 

Further Inpatient Care

Inpatient admission can facilitate a more rapid diagnostic workup; if deterioration has been rapid with a high degree of suspicion, a brain biopsy may be advisable. This is completed over 2 days with initial contact made by a case manager. Referral for brain biopsy then can be expedited and the procedure carried out on the same admission.

Next

Further Outpatient Care

Periodic follow-up is appropriate to adjust dopaminergic medications or treatment for depression or other conditions. It may also help the caregiver to make plans for future care when the patient becomes more disabled.

Previous
Next

Complications

Patients with cerebral atrophy can develop subdural hematoma after a spinal tap. Some physicians admit for 23-hour observation when performing LP to observe for headache, sleepiness, or other changes in mental status.

Previous
Next

Prognosis

  • Unfortunately, this disorder is progressive, leading to increased cognitive and motor disability.
  • Aspiration pneumonia or other complications are usually the cause of death after the patient has lost the ability to care for him/herself and has lost mobility.
Previous
Next

Patient Education

  • A geriatric case manager can be very helpful in counseling the patient and family about the prognosis, community resources, need for supervision, etc.
  • Massachusetts General Hospital (ie, Harvard neurology program) provides links to an online forum and chat rooms for patients and their families. Some may find them helpful sources of information and support.
  • For quality care, screen patients with movement disorders for fall risk by inquiring whether patients have had 2 or more falls over the past year or one or more falls with injury. Such patients would be eligible for physical therapy assessment and aggressive fall prevention via environmental management and caregiver/patient education.
Previous
 
Contributor Information and Disclosures
Author

Anna M Barrett, MD  Director, Stroke Rehabilitation Research Program, Kessler Foundation Research Center; Professor of Physical Medicine and Rehabilitation and Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Anna M Barrett, MD is a member of the following medical societies: American Academy of Neurology, American Society of Neurorehabilitation, and International Neuropsychological Society

Disclosure: Pfizer/Eisai Grant/research funds Other; Wallerstein Foundation for Geriatric Improvement Grant/research funds Speaking and teaching; O'Brien Technologies Grant/research funds Independent contractor

Specialty Editor Board

Stephen T Gancher, MD  Adjunct Associate Professor, Department of Neurology, Oregon Health Sciences University

Stephen T Gancher, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, and Movement Disorders Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Nestor Galvez-Jimenez, MD, MSc, MHA  Chairman, Department of Neurology, Program Director, Movement Disorders, Department of Neurology, Division of Medicine, Cleveland Clinic Florida

Nestor Galvez-Jimenez, MD, MSc, MHA is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society

Disclosure: Nothing to disclose.

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Chief Editor

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Acknowledgments

The author would like to thank Natalie Staats Reiss, PhD for assisting with the update of this article.

References

  1. Benito-León J, Alvarez-Linera J, Louis ED. Neurosyphilis masquerading as corticobasal degeneration. Mov Disord. Nov 2004;19(11):1367-70. [Medline].

  2. Bergeron C, Pollanen MS, Weyer L. Unusual clinical presentations of cortical-basal ganglionic degeneration. Ann Neurol. Dec 1996;40(6):893-900. [Medline].

  3. Boeve BF, Maraganore DM, Parisi JE et al. Pathologic heterogeneity in clinically diagnosed corticobasal degeneration. Neurology. Sep 11 1999;53(4):795-800. [Medline].

  4. Fahn S, Przedborski S. Parkinsonism. In: Rowland LP, ed. Merritt's Textbook of Neurology. 11th ed. Baltimore: Williams & Wilkins; 2005:720.

  5. Feany MB, Mattiace LA, Dickson DW. Neuropathologic overlap of progressive supranuclear palsy, Pick's disease and corticobasal degeneration. J Neuropathol Exp Neurol. Jan 1996;55(1):53-67. [Medline].

  6. Fukui T, Sugita K, Kawamura M. Primary progressive apraxia in Pick's disease: a clinicopathologic study. Neurology. Aug 1996;47(2):467-73. [Medline].

  7. Gibb WR, Luthert PJ, Marsden CD. Corticobasal degeneration. Brain. Oct 1989;112 ( Pt 5):1171-92. [Medline].

  8. Heilman KM. The apraxia of CBGD. Mov Disord. 1996;11:348.

  9. Heilman KM, Rothi LJG. Apraxia. In: Heilman KM, Valenstein E, eds. Clinical Neuropsychology. 2nd ed. New York: Oxford University Press; 1985:131-50.

  10. Kertesz A. Frontotemporal dementia, Pick disease, and corticobasal degeneration. One entity or 3? 1. Arch Neurol. Nov 1997;54(11):1427-9. [Medline].

  11. Kertesz A, Hudson L, Mackenzie IR. The pathology and nosology of primary progressive aphasia. Neurology. Nov 1994;44(11):2065-72. [Medline].

  12. Kertesz A, McMonagle P, Blair M, Davidson W, Munoz DG. The evolution and pathology of frontotemporal dementia. Brain. Sep 2005;128(Pt 9):1996-2005. [Medline].

  13. Kertesz A, Munox DG. Pick's Disease and Pick complex. New York: Wiley-Liss; 1998.

  14. Kompoliti K, Goetz CG, Boeve BF. Clinical presentation and pharmacological therapy in corticobasal degeneration. Arch Neurol. Jul 1998;55(7):957-61. [Medline].

  15. Lang AE, Riley DE, Bergeron C. Cortical-basal ganglionic degeneration. In: Calne DB, ed. Neurodegenerative Diseases. Philadelphia: WB Saunders; 1994:877-94.

  16. Leiguarda R, Lees AJ, Merello M. The nature of apraxia in corticobasal degeneration. J Neurol Neurosurg Psychiatry. Apr 1994;57(4):455-9. [Medline].

  17. McMonagle P, Blair M, Kertesz A. Corticobasal degeneration and progressive aphasia. Neurology. Oct 24 2006;67(8):1444-51. [Medline].

  18. Paulus W, Selim M. Corticonigral degeneration with neuronal achromasia and basal neurofibrillary tangles. Acta Neuropathol (Berl). 1990;81(1):89-94. [Medline].

  19. Rebeiz JJ, Kolodny EH, Richardson EP Jr. Corticodentatonigral degeneration with neuronal achromasia. Arch Neurol. Jan 1968;18(1):20-33. [Medline].

  20. Riley DE, Lang AE, Lewis A. Cortical-basal ganglionic degeneration. Neurology. Aug 1990;40(8):1203-12. [Medline].

  21. Sakurai Y, Hashida H, Uesugi H. A clinical profile of corticobasal degeneration presenting as primary progressive aphasia. Eur Neurol. 1996;36(3):134-7. [Medline].

  22. Sano M, Ernesto C, Thomas RG. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med. Apr 24 1997;336(17):1216-22. [Medline].

  23. Schofield EC, Caine D, Kril JJ, Cordato NJ, Halliday GM. Staging disease severity in movement disorder tauopathies: brain atrophy separates progressive supranuclear palsy from corticobasal degeneration. Mov Disord. Jan 2005;20(1):34-9. [Medline].

  24. Watts RL, Williams RS, Growden JD. Corticobasal ganglionic degeneration. Neurology (Cleveland). 1985;35 (Suppl 1):178.

  25. Borroni B, Garibotto V, Agosti C, Brambati SM, Bellelli G, Gasparotti R. White matter changes in corticobasal degeneration syndrome and correlation with limb apraxia. Arch Neurol. Jun 2008;65(6):796-801. [Medline].

  26. Boxer AL, Geschwind MD, Belfor N, Gorno-Tempini ML, Schauer GF, Miller BL. Patterns of brain atrophy that differentiate corticobasal degeneration syndrome from progressive supranuclear palsy. Arch Neurol. Jan 2006;63(1):81-6. [Medline].

  27. Duda GK, Slowinski J, Opala G, Gorzkowska A, Myga BJ, Wszolek ZK, et al. Corticobasal degeneration-clinicopathological considerations. Folia Neuropathol. 2006;44(4):257-264.

  28. Reich SG, Grill SE. Corticobasal degeneration. Curr Treat Options Neurol. May 2009;11(3):179-85. [Medline].

  29. Takao M, Tsuchiya K, Mimura M, Momoshima S, Kondo H, Akiyama H. Corticobasal degeneration as cause of progressive non-fluent aphasia: clinical, radiological and pathological study of an autopsy case. Neuropathology. Dec 2006;26(6):569-78. [Medline].

  30. Togasaki DM, Tanner CM. Epidemiologic aspects. Adv Neurol. 2000;82:53-9. [Medline].

  31. Wenning GK, Litvan I, Jankovic J, Granata R, Mangone CA, McKee A, et al. Natural history and survival of 14 patients with corticobasal degeneration confirmed at postmortem examination. J Neurol Neurosurg Psychiatry. Feb 1998;64(2):184-9. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.