Progressive Supranuclear Palsy (PSP)

What is progressive supranuclear palsy?

Progressive supranuclear palsy (PSP) is a rare brain disorder that causes severe problems with walking and balance. It also causes difficulties with eye movements and, as time goes on, swallowing complications.

This disorder is also known as Steele-Richardson-Olszewski syndrome.

Prognosis of the disease

This rare disorder is serious, as it progressively worsens over the years, causing severe, life-threatening complications:

  • Swallowing problems
  • Pneumonia

As there is no cure for the pathology, treatment efforts are based on controlling the symptomatology to facilitate the patient’s life.

Difficulty walking is a common feature of PSP.

Symptoms of progressive supranuclear palsy

There are several characteristic symptoms of the pathology, including:

  • Loss of balance when walking.
  • Inability to aim the eyes properly, and may experience double or blurred vision.

In addition, there are other signs that can be seen in some patients and, in general, worsen as time goes by:

  • Habitual falling.
  • Clumsy movements or stiffness.
  • Difficulty speaking
  • Difficulty swallowing
  • Sleep disturbances
  • Sensitivity to light
  • Anxiety
  • Difficulty in memorizing or reasoning
  • Depression
  • Loss of interest in leisure activities
  • Stiffness in facial muscles

Medical tests for progressive supranuclear palsy

The disorder can be complex to diagnose because of the similarity of symptoms to Parkinson’s disease. In any case, the specialist can determine the difference guided by the following signs:

  • Lack of tremor.
  • No or inadequate response to medications for Parkinson’s patients.
  • Difficulty in moving the eyes properly, especially downward.

In terms of testing, MRI can be used to determine if there is shrinkage in specific areas of the brain related to PSP, as well as to exclude other pathologies such as stroke. Finally, positron emission tomography can help determine if there are early signs of changes in the brain.

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What are the causes of progressive supranuclear palsy?

The cause of the disorder is not known, but it is known that the symptoms result from the deterioration of cells in areas of the brain, particularly those that help control thinking and body movements.

A genetic link has also not been established, so the disorder is not usually inherited.

Is it preventable?

There is no known risk factor other than age. This is because progressive supranuclear palsy usually affects patients in their 60s, with virtually no cases in people under 40 years of age.

Treatments for progressive supranuclear palsy

So far there is no cure for the disorder, but there are several options to alleviate the symptoms. Some of the treatments are as follows:

  • Occupational therapy and physiotherapy: with the help of a specialist, balance and movement can be improved.
  • Parkinson’s medications: These can increase levels of the brain chemical involved in smooth, controlled muscle movements. These medications have limited efficacy and are usually temporary (effectiveness lasts about 2-3 years).
  • Glasses with bifocal lenses or prisms: help the patient to look down without the need to move the eyes in that direction.
  • Botox: if injected into the muscles around the eyes, it allows blocking the chemical signals that cause the muscles to contract, improving eyelid spasms.
  • Exercises to improve speech and achieve safe swallowing.

What specialist treats it?

Progressive supranuclear palsy should be treated by a specialist in neurology. In addition to this specialist, other professionals in Physiotherapy, Rehabilitation or Speech Therapy, among others, are involved.