eMedicine Specialties > Neurology > Movement and Neurodegenerative Diseases

Cortical Basal Ganglionic Degeneration: Follow-up

Author: Anna M Barrett, MD, Director, Stroke Rehabilitation Research Program, Kessler Medical Rehabilitation Research and Education Corporation; Associate Professor of Physical Medicine and Rehabilitation and Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Contributor Information and Disclosures

Updated: Jul 9, 2007

Follow-up

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.

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.

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.

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.

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.

Miscellaneous

Special Concerns

  • While the patient is able to participate meaningfully, legal issues such as durable power of attorney, living will, and wishes regarding disposition can and should be addressed sensitively.
 


More on Cortical Basal Ganglionic Degeneration

Overview: Cortical Basal Ganglionic Degeneration
Differential Diagnoses & Workup: Cortical Basal Ganglionic Degeneration
Treatment & Medication: Cortical Basal Ganglionic Degeneration
Follow-up: Cortical Basal Ganglionic Degeneration
References
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References

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Further Reading

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Keywords

corticobasal degeneration, corticodentatonigral degeneration with neuronal achromasia, corticonigral degeneration with neuronal achromasia, extrapyramidal apractic syndrome, Pick complex disorders, Rebeiz disease, apraxia

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Contributor Information and Disclosures

Author

Anna M Barrett, MD, Director, Stroke Rehabilitation Research Program, Kessler Medical Rehabilitation Research and Education Corporation; Associate 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 Neurological Association, American Society of Neurorehabilitation, International Neuropsychological Society, and Society for Neuroscience
Disclosure: Nothing to disclose.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Nestor Galvez-Jimenez, MD, Program Director of Movement Disorders, Department of Neurology, Division of Medicine, Director of Neurology Residency Training Program, Cleveland Clinic Florida
Nestor Galvez-Jimenez, MD is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor of Neurology, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida College of Medicine, Tampa General Hospital
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: Nothing to disclose.

Chief Editor

Nicholas Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
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