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Case Reports
. 2023 Aug 29;23(1):312.
doi: 10.1186/s12883-023-03360-x.

Primary lateral sclerosis plus parkinsonism: a case report

Abhaya Moturu  1   2 , Wade Welch  3
Affiliations
Case Reports

Primary lateral sclerosis plus parkinsonism: a case report

Abhaya Moturu et al. BMC Neurol. .

Abstract

Background: The standard of diagnosing primary lateral sclerosis, the Pringle criteria, requires three years of purely upper motor neuron symptom presentation before confirming diagnosis. This classic standard has been questioned on occasion due to its restrictive range of both time period and symptomatic exhibition.

Case presentation: This case report will review a 57-year-old Caucasian female who presented with pyramidal and extrapyramidal features suggestive of the exceedingly rare disease primary lateral sclerosis plus parkinsonism. We will describe the mixture of upper motor neuron signs and striking parkinsonian symptoms experienced by the patient, as well as the full diagnostic workup leading to her preliminary diagnosis. The details of this case will then be utilized to explore the diagnostic criteria of primary lateral sclerosis, as well as to work through the differential of conditions resembling Parkinson's disease.

Conclusions: The current criteria to diagnose primary lateral sclerosis may be excluding patients with the disease and is an ongoing area of investigation. A thorough differential including other neurodegenerative conditions is necessary to consider and requires long-term follow-up.

Keywords: Extrapyramidal features; Parkinsonism; Primary lateral sclerosis; Pyramidal features; Upper motor neuron symptoms.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
MRI brain imaging nine months after symptomatic onset. Left to right–T1 axial view; T1 sagittal view; T2 axial view
Fig. 2
Fig. 2
MRI brain imaging two years after symptomatic onset. Left to right–T1 axial view; T1 sagittal view; T2 axial view
Fig. 3
Fig. 3
DaTscan (1–123 ioflupane) one year after symptomatic onset
See this image and copyright information in PMC

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