Progressive supranuclear gaze palsy without parkinsonism: a case of neuro-Whipple

Parkinsonism Relat Disord. 2007 Oct;13(7):449-52. doi: 10.1016/j.parkreldis.2006.05.035. Epub 2006 Oct 30.

Abstract

We report the case of a 69-year-old man with a 7-month history of severe progressive supranuclear gaze palsy associated with mild cognitive decline and sleep disturbances, but not parkinsonism. After a period spent consulting a range of different specialists, the appearance of brachial myoclonus prompted his referral to a movement disorders specialist. Duodenum biopsy confirmed the suspicion of neuro-Whipple disease. Antibiotic therapy was started but the delay in the diagnosis proved fatal to this patient. This noteworthy case shows unusual neurological features of a rare but treatable disease, often misdiagnosed as progressive supranuclear palsy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cognition Disorders / etiology*
  • Diagnosis, Differential
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Parkinson Disease / diagnosis
  • Sleep Wake Disorders / etiology
  • Supranuclear Palsy, Progressive / complications*
  • Supranuclear Palsy, Progressive / pathology*