Progressive Supranuclear Palsy
Progressive supranuclear palsy (PSP) is an atypical form of parkinsonism that can initially look very similar to Parkinson's disease (PD). PSP affects persons 40 years of age and older and has a rapid progression of symptoms unlike PD in which symptoms progress relatively slowly. Persons with PSP often experience unexplained falling as an early symptom of the disease as well as early signs of speech difficulty and cognitive problems. Persons with PD may also experience these symptoms, but they tend to occur later in the course of the disease. Slowness and stiffness are generally present, although stiffness is more severe in the neck, often leading to an abnormal posturing of the neck with PSP whereas stiffness is more common in the arms and legs with PD. Tremor is generally minimal or absent in persons with PSP. With PSP there are often abnormalities of eye movements where it is very difficult to move the eyes upward or downward. In addition, PSP often begins with symptoms on both sides of the body and walking can be uncontrolled with the feet often being farther apart than normal (wide-based gait). Treatment options for PSP are limited. Levodopa may provide some benefit early in the disease, but this is generally minimal and does not last long-term. Speech, physical and occupational therapy can be very helpful as well as psychiatric assessment for depression and cognitive issues.