CBGD vs PSP

[Jackie Gomes]

Hello Chrissy,

Have I got it right that with CBGD the problem is more difficulty with horizontal and upward gaze and with PSP it is more difficulty with downward gaze?
If so in reference to Case 10 – Question 1, as the patient has difficulty looking above eye level should the answer be CBGD? She does have dementia which could be either one and does have postural instability and falls which leans to PSP and no mention of ‘alien limb’ which would lean to CBGD. But yet just wanted to check about the direction difficulty of gaze.

Thanks,
Jackie

[Chrissy Durrough Lugge]

Hi Jackie! Thanks for this question! PSP is associated with vertical (both up and down) gaze paresis, as well as an increased likelihood of falling backward.

CBGD is more marked by dystonia, apraxia, and rigidity. Oculomotor and gaze changes are possible with CBGD but are less typical.

This article is more detailed than you’ll need for NCS prep, but the background does a nice job of describing the expected presentation for PSP and CBGD: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174492/

Hope this helps!

Chrissy

[Chrissy Durrough Lugge]

Hi Jackie! Thanks for this question! PSP is associated with vertical (both up and down) gaze paresis, as well as an increased likelihood of falling backward.

CBGD is more marked by dystonia, apraxia, and rigidity. Oculomotor and gaze changes are possible with CBGD but are less typical.

This article is more detailed than you’ll need for NCS prep, but the background does a nice job of describing the expected presentation for PSP and CBGD: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174492/

Hope this helps!

Chrissy

[Jackie Gomes]

Thanks Chrissy, your answer really clarifies it well.
Sure appreciate it!

Thanks,
Jackie

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