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A Proposed Clinical Classification

Richard J. Caselli, MD; Clifford R. Jack, Jr, MD

Arch Neurol. 1992;49(7):770-780.

Abstract
• Twenty-six patients presented with slowly progressive focal neurologic symptoms that conformed clinically to one of three categories: aphasia, perceptuomotor dysfunction, or neuropsychiatric dysfunction. Of 12 patients with progressive aphasia, seven were dysfluent and five were fluent. Nine patients had progressive perceptuomotor impairment due to bilateral parietal lobe atrophy, which also included frontal lobe signs in seven patients and occipital lobe signs in three patients. The right hemisphere was more severely involved in five patients and the left hemisphere in four. Five patients had a progressive neuropsychiatric syndrome, and there was also generalized spasticity in three patients due to frontal lobe atrophy. The clinically suspected anatomic localization of cortical atrophy or hypoperfusion in all three categories was confirmed with neuroimaging techniques. A brain biopsy specimen from one patient showed mild, nonspecific degenerative changes. A clinical classification scheme incorporating our observations as well as the observations of others is presented to aid in the recognition of these syndromes.

Author Affiliations
From the Section of Neurology, Mayo Clinic Scottsdale (Ariz) (Dr Caselli); and the Section of Neurologic Radiology, Mayo Clinic and Mayo Foundation, Rochester, Minn (Dr Jack).

Footnotes
Accepted for publication March 11, 1992.

Presented, in part, at the 42nd annual meeting of the American Academy of Neurology, Miami Beach, Fla, May 2, 1990.

Reprint requests to Section of Neurology, Mayo Clinic Scottsdale, 13400 Shea Blvd, Scottsdale, AZ 85259 (Dr Caselli).

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