Corticobasal Syndrome (CBS)

Corticobasal syndrome (CBS), characterized by a range of cortical and basal ganglia deficits, embodies a myriad of clinical manifestations including atremulous parkinsonism, rigidity, and higher cortical sensory deficits. Pathologies of CBS are heterogeneous, including corticobasal ganglionic degeneration, Pick’s disease, and Alzheimer’s disease, among others. Patients navigate through their clinical course distinguished by relentlessly progressive and disabling milestones, extending from declining hand dexterity to profound neurological impairments. Brain magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET) can serve as ancillary tools for the diagnosis. The management of CBS intertwines symptomatic treatments, such as levodopa for parkinsonism and levetiracetam for myoclonus, with palliative care approaches. The conundrum, however, remains nestled in the diagnostic intricacies, unfolding through variable presentations and ‘overlap’ syndromes, requiring a framework that aligns comprehensive diagnosis with empathic, palliative, and symptom-targeted care. This chapter reviews the diagnostic and therapeutic challenges, highlighting an integrated care approach that straddles precise medical and compassionate patient-centered care.