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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 338:603-610 February 26, 1998 Number 9
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Case 7-1998— A 74-Year-Old Man with Dementia, Parkinsonism, and an Insular Lesion
M. Flint Beal, and Jean-Paul Vonsattel

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Presentation of Case

A 74-year-old right-handed man was admitted to the hospital because of slowly progressive motor and cognitive difficulties and a right insular lesion.

The patient had been well until 52 months earlier, when depression with prominent fatigue, sleep perversion, and severe anxiety developed after the excision of a pleomorphic adenoma of the parotid gland. Amitriptyline was administered, but it made the patient drowsy and confused and was discontinued. Thirty-three months before admission, the patient's family informed his physician that the patient had been disoriented, had memory deficits, and had been unable to calculate a tip at a restaurant. The results of . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnoses

Dr. M. Flint Beal's Diagnoses

Pathological Discussion

Anatomical Diagnoses

References



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