Clinical features of corticobasal syndrome and associated chronic pain:analysis of 8 cases
10.3760/cma.j.cn114798-20201222-01277
- VernacularTitle:皮质基底节综合征八例临床特点及其伴慢性疼痛的临床特征初探
- Author:
Dongdong WU
1
;
Wen SU
;
Shuhua LI
;
Jing HE
;
Ying JIN
;
Haibo CHEN
;
Huiyan YU
;
Shiguang WEN
;
Yinhong LIU
;
Jingwen JIANG
Author Information
1. 北京医院神经内科 国家老年医学中心 中国医学科学院老年医学研究所 100730
- Keywords:
Parkinsonian disorders;
Tauopathies;
Pain
- From:
Chinese Journal of General Practitioners
2021;20(8):863-867
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical features and associated chronic pain in corticobasal syndrome (CBS).Methods:Clinical data of 8 patients diagnosed as probable CBS or possible CBS admitted to Beijing Hospital during January 2010 to June 2020 were retrospectively analyzed. The clinical information included sex, age, course of disease, chief complaint, neurological examination, blood biochemistry, tumor marker, infection and other laboratory tests; the neuropsychological evaluation included Mini-Mental State Examination (MMSE) scale and Hamilton Depression Scale (HAMD); the imaging studies included cranial magnetic resonance imaging (MRI) and/or 18F-Fluorodeoxyglucose positron emission tomography ( 18F-FDG PET). Results:The main clinical manifestations were asymmetrical movement disorders, including rigidity, tremor, myoclonus and abnormalities in posture and gait. Patients showed poor response to levodopa treatment. Among 8 patients, 7 had apraxia, 5 patients had alien hand, and 5 patients had various degrees of cognitive dysfunction. The cranial MRI demonstrated mild cerebral atrophy which was slightly more severe in the contralateral side of the initially affected limb in 7 of the 8 patients. The 18F-FDG PET scan revealed asymmetric decreased metabolism in the frontal, parietal, temporal, and occipital lobe, as well as in basal ganglia, which was more severe in the contralateral side of the initially affected limb in 5 of the 8 patients. Six of the 8 patients were associated with pain, including dystonic pain in 3 patients, neuropathic pain in 1 patient, musculoskeletal pain in 1 patient, and unexplained pain in 1 patient. Pain was the onset symptom in 1 patient and pain was relieved by taking levodopa in another patient. Conclusions:CBS is characterized by asymmetric dyskinesia and cognitive impairment, and often associated with apraxia, cortical sensory deficits, and alien limb. The MRI and PET are helpful for CBS diagnosis. Pain may be one of the common non-motor symptoms in CBS.
