Diffuse Intracytoplasmic Ganglionic Inclusions (Lewy Type) Associated with Progressive Dementia and Quadriparesis in Flexion

Intraganglionic inclusion bodies of presumably non-viral ongm have been associated with a range of defined neurologic disturbances, including myoclonus epilepsy (1), Pick's disease (2), and Parkinson's disease (3). In each of these entities the inclusions present a pattern of characteristics (histochemical and histologic properties, topographical distribution and size) which permits a degree of diagnostic differentiation. In the Parkinsonian states, the inclusion is typically intracytoplasmic, and most frequently encountered in the pigmented neurons of the mesencephalic and rhombencephalic nuclei (4). Two elderly patients with progressive dementia associated with quadriparesis in flexion, and without any Parkinsonian stigmata, have been studied, demonstrating at autopsy widely disseminated intracytoplasmic ganglionic inclusions morphologically and histochemically indistinguishable from those initially described by Lewy in Parkinson's disease (paralysis agitans).