Clinical Reasoning: A 35-Year-Old Woman With Personality Change and Gait Impairment.

Bernardes, Catarina; Lemos, João M; Santo, Gustavo C · Neurology · 2025

case_report · Level V

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Abstract

A 35-year-old woman presented with a progressive 3-year history of personality changes and gait impairment. Neurologic examination revealed bilateral optic atrophy, spastic paraparesis, and impaired vibratory sensation in all limbs, and neuropsychological evaluation identified a frontotemporal cognitive impairment. In this article, we review the differential diagnosis for a young woman with chronic frontotemporal dysfunction, optic atrophy, and dorsolateral myelopathy in a stepwise multidisciplinary approach. Critical information obtained from the medical history led to a final diagnosis.

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