Further Outpatient Care

Periodic follow-up is appropriate to adjust dopaminergic medications, levetiracetam or clonazepam for myoclonus, inject botulinu toxin for dystonia or sialorrhea, treat depression/anxiety or other conditions. It may also help the caregiver to make plans for future care as the patient becomes more disabled.

Further Inpatient Care

Inpatient admission can facilitate a more rapid diagnostic workup as outlined in the Overview; if deterioration has been rapid with a high degree of suspicion, a brain biopsy may be advisable.

Complications

Patients with significanat cerebral atrophy can develop subdural hematoma after a lumbar puncture, a fall, or spontaneously. See list of complications in the Overview section.

Prognosis

Corticobasal degeneration (CBD) is a progressive disorder, leading to increased cognitive and motor disability. Average course of the disease is about 7 years from symptom onset to death and about 4.6 years from diagnosis to death, although survival beyond 12 years has been reported.

Aspiration pneumonia, urosepsis, traumatic falls with head injury or other complications are the most frequent causes of death.^[18]

Patient Education

A Social Worker or geriatric case manager can be very helpful in counseling the patient and family about community resources, need for supervision, etc. CurePSP has a free guide for Social Workers and rehabilitation specialists conerning CBD, PSP, and MSA: https://www.psp.org/wp-content/uploads/2016/08/ALLIED-HEALTH-BROCHURE_web.pdf

Information for patients and families, guidelines for rehabilitation, and virtual support groups specific to CBS/CBD can be found at https://www.psp.org/

Additional information from the Institute for Neurological Disorders and Stroke: https://www.ninds.nih.gov/Disorders/All-Disorders/Corticobasal-Degeneration-Information-Page

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Author

Alexander Pantelyat, MD Assistant Professor, Department of Neurology, Johns Hopkins University School of Medicine; Director, Johns Hopkins Atypical Parkinsonism Center; Co-Director, Johns Hopkins Center for Music and Medicine; Co-Director, Johns Hopkins Movement Disorders Fellowship Program

Alexander Pantelyat, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, International Association for Music and Medicine, International Parkinson and Movement Disorder Society, Maryland State Medical Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: MedRhythms, Inc.; Biosensics, Inc.; Ono Pharma; CurePSP<br/>Received research grant from: NIH.

Coauthor(s)

Maitreyi Murthy, MBBS, MPhil Clinical and Research Fellow, Department of Neurology, Movement Disorders Division, Johns Hopkins University School of Medicine

Maitreyi Murthy, MBBS, MPhil is a member of the following medical societies: American Academy of Neurology, Movement Disorder Society

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Nestor Galvez-Jimenez, MD, MSc, MHA The Pauline M Braathen Endowed Chair in Neurology, 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, International Parkinson and Movement Disorder Society

Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida Morsani 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, American Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Bioserenity, Ceribell, Eisai, Jazz, LivaNova, Neurelis, Neuropace, SK life science, Sunovion, Takeda, UCB<br/>Serve(d) as a speaker or a member of a speakers bureau for: Aquestive, Bioserenity, Eisai, Jazz, LivaNova, Neurelis, SK life science, Stratus, Sunovion, UCB<br/>Received research grant from: Cerevel Therapeutics, Ovid Therapeutics, Neuropace, Greenwich Jazz, SK Life Science, Xenon Pharmaceuticals, UCB, Marinus, Neuroelectrics Corporation, Longboard, Janssen, Equilibre Biopharmaceuticals.

Additional Contributors

A M Barrett, MD, FAAN, FANA, FASNR Chair, Department of Neurology, UMass Chan Medical School and UMass Memorial Healthcare; Chief, Neurology, Central Western Massachusetts VA Healthcare System

A M Barrett, MD, FAAN, FANA, FASNR is a member of the following medical societies: American Academy of Neurology, American Society of Neurorehabilitation, International Neuropsychological Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Kessler Foundation<br/>Received research grant from: SPR Therapeutics; DART Neuroscience; Wallerstein Foundation for Geriatric Improvement; NJ Commission on Brain Injury Research; NIDILRR; NIH.

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, International Parkinson and Movement Disorder Society

Disclosure: Nothing to disclose.

Acknowledgements

Thanks are owed to the family of the man who provided medical records for the author's review, to confirm that pathologically confirmed corticobasal syndrome has occurred with onset before age 45 years.