Movement Disorders USMLE Step 1 Practice Question
A 42-year-old woman presents with a 6-year history of progressive rigidity, dysarthria, and frequent episodes of sudden-onset involuntary muscle contractions causing abnormal neck and trunk posturing. She reports constipation, urinary urgency, and orthostatic dizziness. On examination, she has generalized bradykinesia, cogwheel rigidity, and hyperreflexia. Brain MRI demonstrates atrophy of the putamen and midbrain tegmentum. Which of the following is the most likely diagnosis?
Answer choices
- AMultiple system atrophyCorrect answer
- BParkinson disease with secondary dystonia
- CProgressive supranuclear palsy
- DWilson disease
- EPrimary dystonia with Parkinsonian features
- FHereditary spastic paraplegia
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