LAUSR

A 68-year-old woman presented with an insidious onset of strictly asymmetric left arm clumsiness (video at Neurology.org) in absence of any brain lesion but mild right hemisphere hypotrophy (figure). The presence of limb apraxia and bradykinesia fostered the clinical diagnosis of possible corticobasal syndrome, in the context of suspected corticobasal degeneration.1 Bradykinesia and apraxia are 2 possible different faces of hypokinesia; their correct discrimination is not a diagnostic problem if a higher-level disturbance of praxis is present. An isolated limb apraxia is a confounder, and its early recognition allows clinicians to suspect parkinsonism with apraxia as a prominent feature.2