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Clinical History: A 57‐year old woman presented with left hand pain, periodic leg movement during sleep, gradual onset of stiffness, clumsiness, and falls. Neurological examination showed: generalized rigidity and bradykinesia. There was left hand dystonic posturing and ideomotor apraxia, as well as mirror movements of upper limbs and stimulus‐sensitive myoclonus. The patient had a high‐pitched voice and hypophonia (Video S1). Discussion: Experts discuss localization and the syndromic diagnosis and predict the underlying pathology. The pathological diagnosis is then provided and clinical learning points are considered. View Supplementary Video 1 [ABSTRACT FROM AUTHOR]

Keywords: Transcranial sonography; corticobasal degeneration EN Transcranial sonography corticobasal degeneration 581 582 2 07/03/20 20200701 NES 200701 We thank Dr. Daniel Richter and colleagues for their comments on our recently published I Movement Disorders Clinical Practice i ( I MDCP i ) article.[[1]] We welcome any guidance with regard to the diagnosis of atypical parkinsonism given that it can often be difficult especially at the first assessment. The diagnosis is still a clinical diagnosis, and we await validation of various biomarkers to guide accurate diagnosis. Transcranial sonography (TCS) is one of these noninvasive biomarkers, and Richter and colleagues emphasise its role in distinguishing between idiopathic Parkinson's disease (IPD), MSA, PSP, and corticobasal syndrome (CBS). [Extracted from the article]