Progressive Supranuclear Palsy
Progressive supranuclear palsy (PSP) is a late onset (after age 40 years), progressive neurodegenerative condition traditionally considered a movement disorder. In its classic form, the movement disorder is characterized by early postural instability and falls. Patients with PSP may show the “rocket sign” arising rapidly from a chair just to fall back into it. Other clinical features include symmetrical bradykinesia and greater axial than limb rigidity. Oculomotor problems usually begin with slowing of vertical saccades, with eventual vertical (greater downward than upward) gaze restriction. Problems with downward gaze can manifest in messy eating (hence the “messy tie” sign). Diminished blinking can lead to subjective complaints of blurred vision and sore or tired eyes, and patients may show eyelid apraxia (inability to voluntarily move the eyelids). Speech can be affected early in PSP and may involve hypophonia (reduced volume)...
References and Readings
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