Corticobasal Syndrome

Corticobasal Syndrome, or CBS, (also referred to as Corticobasal Degeneration) is a progressive, atypical parkinsonian disorder caused by the accumulation of the abnormally folded protein tau in the nervous system. While there are rare cases of genetic mutations causing CBS, it is widely accepted that CBS is not a genetic disease and that the precise cause is largely unknown. 

There are many faces, or subtypes of CBS, but many will showcase progressive troubles on one side of the body almost as if that side is “shutting down.” Stiffness, slowness, and trouble with tasks with the affected side are common, as can be abnormal posturing, jerks, or other involuntary movements (aka ‘alien limb’ phenomenon). Symptoms vary widely from patient-to-patient, but some may additionally have troubles with speech, language, thinking, or balance. Eventually, both sides can become affected although never to the same degree as the initially affected side. 

For most, the progression of CBS is relatively slow, over years, but more rapid compared to typical Parkinson Disease and more rapid than all would like. 

CBS Treatment

Although there is no one pill or cure for CBS, we can and do try to treat the symptoms one faces, whether this be trouble with slowness or stiffness in movement, or other troubles such as falls or pain in the affected limb. In most, a trial of carbidopa-levodopa (Sinemet) is warranted to treat symptoms of slowness and stiffness but in contrast to Parkinson Disease, the effect of Sinemet in CBS for these symptoms may be minimal. 

Many patients living with CBS will need frequent evaluations and support services from physical, occupational, and speech-swallow therapists, whether at an outpatient rehab center or in the home. In general, physical therapy is crucial to help with gait, balance, fall prevention, and mobility while occupational therapy helps with activities of daily living like getting dressed, going to the bathroom, and eating. As speech and swallowing are often affected in CBS, speech-swallow therapy is frequently prescribed and can be very helpful to improve speech and prevent aspirating foods-liquids. 

Staying active is critical and any exercise you like to do and tolerate is highly recommended.

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