Progressive Supranuclear Palsy

Similar to Parkinson's Disease, PSP Is a Degenerative Brain Disorder

Senior African American couple, man in wheelchair
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British actor, writer, and musician Dudley Moore died on March 27, 2002. The official cause of death was pneumonia, but in truth, Moore had been battling progressive supranuclear palsy for many years (although he only publicly admitted to having the disease in September 1999).

What Is Progressive Supranuclear Palsy?

Progressive supranuclear palsy (PSP) is a degenerative brain disorder that gets worse over time.

Its symptoms come from the gradual deterioration of brain cells in the part of the brain that controls vision and movement (brainstem). PSP is sometimes called Steele-Richardson-Olszewski syndrome, after the physicians who first identified it as being related to Parkinson's disease but a distinct disorder in itself. Its cause is unknown.

PSP is estimated to affect 1.4 people per 100,000 around the world. Men are affected slightly more than women, and symptoms typically begin between the ages of 50 and 60 years old.

Symptoms: Often Misdiagnosed

The most obvious and characteristic symptoms of PSP involve vision problems, such as light sensitivity, double and blurred vision. This occurs because people with PSP are unable to aim their eyes properly. Other symptoms may include:

  • Difficulty or unsteady walking and keeping one's balance
  • Slow movements
  • Prone to accidents and falling down, which often give the appearance of alcohol abuse.
  • Trouble swallowing and speaking (slurring of words is common)
  • Suffer from memory loss
  • Have difficulty thinking
  • There may be mood changes such as depression
  • A progressive, mild dementia

The symptoms of PSP increase over time and are often first misdiagnosed as Alzheimer's disease, or an inner-ear problem, or signs of a stroke.

Diagnosis of PSP

Diagnosis is made on the symptoms since there is as yet no imaging or lab tests specific to diagnosing the disorder. The disease is often difficult to diagnose because as mentioned above, its symptoms mimic other movement disorders.

Initial diagnosis is based on medical history, a thorough physical exam and also a neurological exam. An MRI (magnetic resonance imaging) may show shrinkage at the top of the brain stem while other imaging tests can look at brain activity.

Treatment Options

There is no treatment for the disorder itself, so care is directed towards relieving its symptoms. Some patients may respond to the same drugs used to treat Parkinson's disease, such as levodopa. Some antidepressant medications, such as Prozac, Elavil, and Tofranil, seem to also help.

Besides medication, special glasses (such as bifocals or special glasses called prisms), walking devices, and other adaptive aids may help the person with PSP move around. Studies have shown that formal physical therapy sessions have no proven benefit in PSP, but certain exercises may help keep the joints limber. Surgically implanted electrodes and pulse generators used in Deep Brain Stimulation therapy and other surgical procedures used in Parkinson's disease treatment have also not been proven effective in PSP.

 If the person with PSP is unable to swallow, a feeding tube may be inserted into the stomach.

Complications From the Disease

Serious complications of PSP come from head injury and fractures due to falls, and pneumonia due to problems swallowing and coughing. Good medical care and proper nutrition can help someone with PSP live many years, even decades after diagnosis.


National Institute for Neurological Disorders and Stroke. Progressive Supranuclear Palsy Information Page.

The Society for Progressive Supranuclear Palsy. What is PSP?

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