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
From the case:
Progressive supranuclear palsy
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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°).
Case Discussion
The clinical picture and prominent radiological signs confirm the diagnosis of progressive supranuclear palsy.