A 72-year-old woman developed new-onset depression, sustained an unexplained fall, and started walking cautiously. After 1 year, her depression resolved but she developed a dry cough. One year later, she experienced a more rapid decline in her gait with parkinsonism, visual difficulties with restricted vertical gaze, slowed horizontal and vertical saccades, dysphagia, apathy, and progressive cognitive decline, which led to her death 2 years later. The differential diagnosis, neuroimaging, and pathological findings are discussed, as well as their public health implications.
Fernández-Fournier M, Perry DC, Tartaglia MC, et al. Precipitous Deterioration of Motor Function, Cognition, and Behavior. JAMA Neurol. 2017;74(5):591–596. doi:10.1001/jamaneurol.2016.6159
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