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What is the preferred and differential diagnosis?

Multiple system atrophy, cortico-basal degeneration, progressive supranuclear palsy, dementia with Lewy bodies, Pick disease, Parkinson disease

How might imaging help clarify the clinical differential diagnosis?

What other clinical features might characterise the preferred diagnosis?

Orthostatic hypotension, impotence, constipation, Parkinsonism, dry skin, temperature dysregulation, cognitive impairment, REM behaviour disorder

Presentation

Progressive dysphasia and bulbar symptoms including dysphagia and dysphonia. Associated recent history of falls and urinary incontinence.

Age:	65 years
Gender:	Female

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