Neurological examination Early on, the neurological examination may be normal or reveal subtle impairment of rapid limb and eye movements. Later, frontal lobe release signs, tremor, hyperreflexia, clonus, spasticity, weakness, and poor coordination develop. These signs may reflect a concomitant vacuolar myelopathy or neuropathy. The terminal stage of ADC, after progression over several months, includes severe psychomotor retardation and dementia, apraxia, paraparesis, and akinetic mutism. Death ensues within a few months of reaching this stage.
Seizures are rare and warrant exclusion of other conditions.
Gait and strength are normal. Patient able to perform all but the more demanding aspects of work or ADL but has unequivocal evidence of functional, intellectual, or motor impairment. Signs or symptoms may include diminished performance on neuropsychological testing. Patient can walk without assistance. Patient able to perform basic activities of self-care but cannot work or maintain the more demanding aspects of daily life.