Case 39 - Young woman with lateralized motor symptoms

Summary

This chapter describes the lateralized motor symptoms using a case of a 40-year-old woman of Vietnamese origin who was referred with a history of progressive short-term memory decline for 12 months. The initial diagnostic impression was of a progressive dementia of subacute onset in a young individual. An assessment approximately 1 year after her initial presentation showed significant further decline in function and personal hygiene. Gait was wide based and spastic with ataxia and postural instability. She developed fluctuating level of consciousness and appeared encephalopathic with disorientation to person, place and time. The biopsy showed features of a leukoencephalopathic process in combination with dystrophic axonal degeneration characterized by spheroid formation and microglial cell accumulation. The patient died 3 years after the onset of her symptoms. Prior to death, she developed seizures and was put on anti-epileptics.