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NEUROLOGY 1990;40:14
© 1990 American Academy of Neurology

Focal Alzheimer's disease

William J. Jagust, MD, Peter Davies, PhD, Janice K. Tiller-Borcich, MD and Bruce R. Reed, PhD

Departments of Neurology (Drs. Jagust and Reed) and Pathology (Dr. Tiller-Borcich), Veterans Administration Medical Center, Martinez, and the School of Medicine, University of California, Davis, CA; Donner Laboratory (Dr. Jagust), Lawrence Berkeley Laboratory, University of California, Berkeley, CA; and Departments of Pathology and Neuroscience (Dr. Davies), Albert Einstein College of Medicine, Bronx, NY.

Alzheimer's disease is characterized by relative sparing of primary sensory and motor cortex and a lack of sensory or motor symptomatology. We report a case of presenile onset dementia accompanied by a slowly progressive hemi-paresis. Autopsy examination showed severe pathologic involvement of somatosensory cortex with neuritic plaques and neurofibrillary tangles, in addition to degeneration of the nucleus basalis and locus ceruleus. Neurochemical and immunocytochemical studies showed a moderate cortical cholinergic deficiency with normal somatostatin-like immunoreactivity and a profuse immunostaining of somatosensory cortex with the Alz-50 antibody. These unusual features emphasize that Alzheimer's disease is extremely variable in its clinical symptomatology, pathologic distribution, and neurochemical dimensions.

Address correspondence and reprint requests to Dr. William J. Jagust, Department of Neurology (127), Veterans Administration Medical Center, 150 Muir Road, Martinez, CA 94553.

Supported by NIH grants AG07793 and AG05890 from the National Institute on Aging.

Presented in part at the 41st annual meeting of the American Academy of Neurology, Chicago, IL, April 1989.

Received April 3, 1989. Accepted for publication in final form June 27, 1989.




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