“Continuum” is a journal published by the American Academy of Neurology. Its subtitle is “Lifelong Learning in Neurology.” It’s a study-guide for neurologists. Every year or maybe every other year they have an issue devoted to movement disorders. Within that issue, there’s always an article on three parkinsonian syndromes — PSP, MSA, and CBD. This year’s article has two authors — Dr. Irene Litvan, who was the keynote speaker at our October 2012 atypical parkinsonism symposium, and Dr. David Williams, a rising star in the atypical parkinsonism community. (Unfortunately for us, Dr. Williams lives in Australia.)
The study-guide is available at no charge online:
www.ncbi.nlm.nih.gov/pmc/articles/PMC4234134/
Continuum (Minneap Minn). 2013 Oct; 19(5 Movement Disorders): 1189–1212.
Parkinsonian Syndromes
David R. Williams, MD, MBBS, PhD, FRACP and Irene Litvan, MD, FAAN
The CBD-related section of the study-guide has three parts:
#1 – a description of the classic type of CBD. There are actually five types of CBD. CBD-CBS is considered the “classic type.”
Video is available of someone with CBD-CBS, the classic type. Dr. Litvan is heard/seen in this video. She showed us this same video in October 2012. There is a case report of the same woman as in this video. I’d suggest focusing on the case report and the video. There is also new diagnostic criteria for CBD-CBS.
There is also a short description of the CBD-PSP type.
#2 – a two-sentence “natural history.” (Sadly we know so little about CBD.)
#3 – treatment paradigm. Again, this is a very short section. The key sentences are these:
“The most useful symptomatic therapies are those targeting myoclonus (eg, valproic acid, clonazepam, levetiracetam, and piracetam) and dystonia (eg, botulinum toxin) when they affect the patient’s quality of life. Treatment of dystonia is indicated when the contractures cause pain or impede hygiene.”
Robin