DISSOCIATION OF CLINICAL MANIFESTATIONS AND NEUROIMAGING IN PROGRESSIVE SUPRANUCLEAR PALSY (PAIRED CLINICAL CASE OF STEELE-RICHARDSON-OLSHEVSKY SYNDROME)

Relevance. The differential diagnosis of motor neuron diseases is very difficult in practical medical practice. Early diagnosis of this group of diseases, in particular, progressive supranuclear palsy, is of particular importance. In this case, pathognomonic clinical signs and neuroimaging correlates become crucial in verifying the diagnosis.

Cases descriptions.  Paired clinical observations of progressive supranuclear palsy, differing in signs during magnetic resonance imaging of the brain, are presented. The article describes the clinical observations of two patients with progressive supranuclear palsy (Steele-Richardson-Olshevsky syndrome). Detailed clinical characteristics of each case are presented. The data of a magnetic resonance imaging examination of the brain of each patient are presented. In the first case, the characteristic symptoms of "hummingbird" and "Mickey Mouse" were obtained. In the second case, these signs were not detected. Both patients are under dynamic observation, this allows you to quickly assess changes in the clinical neurological status, the results of treatment and carry out preventive work to prevent dangerous complications of the disease (dysphagia, falls). The discussion presents a differential series for progressive supranuclear palsy and possibilities of quantitative automated and manual planimetry in the analysis of magnetic resonance images of the brain.

Conclusion. These approaches to the management of patients with progressive supranuclear palsy contribute to the early diagnosis of the disease, correction of treatment, and prevention of complications.

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