Overlapping MRI findings in progressive supranuclear palsy - corticobasal syndrome.

A 59 year old woman presented with an atypical parkinsonian syndrome with clinical and neuroimaging features of corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP). CBS manifestations were slurred/scanning speech and asymmetrical right signs: levitation phenomena, pseudo-hemiparetic gait and hypertonia/hyperreflexia. PSP signs were staring face and oculomotor apraxia. Neuroimaging revealed midbrain atrophy with asymmetrical cerebral peduncle (CP), tegmental hiperintensity (Figure 1 to 4) and frontal and midbrain hypometabolism (Figure 5). Typical Magnetic Resonance Image (MRI) of PSP presents with midbrain atrophy and hiperintensity while CBS displays asymmetrical frontoparietal and CP atrophy. This case has been clinically classified as PSP-CBS but definite diagnosis is through neuropathology.