Table of Contents
Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 3 LBD - Gross Pathology - Pallidotomy and DBS | 2A0 Case 2 History
Case 2 History ---- The patient was a 79yo male with a history of Parkinsonism since 1972. In the early 1970s he showed progressive slowness of the left hand, shaking of the right upper extremity, slurred speech, difficulty in rising from a chair, slow shuffling gait and a tendency to fall backward. He also had difficulty swallowing. The ”on-off“ phenomena of both rigidity and choreiform movements worsened along with confusion which was new prompting the admission in 1991. The patient, in the course of his illness, underwent a left pallidotomy at Northwestern in October 1996. He was having difficulty feeding himself and his speech was sparse. He was seen in the movement disorders clinic in November 1996 for lethargy with right sided weakness and left gaze preference. CT scan of the head disclosed a small infarct in the right caudate and another lateral and anterior to it. He was therefore felt to have an expressive aphasia, right hemiparesis and stage 5 PD. He developed excessive sleepiness. He could no longer walk, required assistance for all transfers and could no longer feed himself. His thinking was relatively clear but memory was poor. The patient was found dead in his bed at home in September 2000.
