Progressive supranuclear palsy

Case contributed by Yuliia Solodovnikova
Diagnosis certain

Presentation

The patient presented with delayed movements, thought, speech, general stiffness, nighttime insomnia, daytime sleepiness, and emotional lability. Neurological examination revealed a masked face, vertical gaze palsy, bradylalia, extrapyramidal tone, brisk tendon reflexes, pathological reflexes, and bradykinesia.

Patient Data

Age: 60 years
Gender: Female

Diffuse cortical atrophy.

Magnetic resonance parkinsonism index (MRPI): 13.7.

Midbrain/pons area ratio: 0.19 (normal ~ 0.24).

Interpeduncular angle:- 82° (normal ~ up to 53.4°).

Hummingbird sign.

Mickey Mouse sign.

Case Discussion

The clinical picture and prominent radiological signs confirm the diagnosis of progressive supranuclear palsy.

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