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Progressive Supranuclear Palsy

An atypical parkinsonian tauopathy characterized by vertical gaze palsy, postural instability with backward falls, axial rigidity, and progressive cognitive decline.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Progressive Supranuclear Palsy?

Progressive supranuclear palsy (PSP) is a neurodegenerative tauopathy involving the basal ganglia, brainstem, and frontal cortex, with abnormal aggregation of 4R tau protein.

Multiple clinical phenotypes are recognized — Richardson syndrome (classic with gaze palsy and falls), PSP-parkinsonism (asymmetric tremor mimicking Parkinson disease), PSP with progressive gait freezing, PSP with corticobasal syndrome, and PSP with speech and language disturbance.

Diagnosis is clinical, supported by MRI showing 'hummingbird' or midbrain atrophy and reduced midbrain-to-pons ratio; treatment is symptomatic and multidisciplinary because there is no disease-modifying therapy.

Symptoms

Vertical (especially downward) supranuclear gaze palsy
Early postural instability and unexplained backward falls within the first year
Symmetric axial rigidity and bradykinesia with poor levodopa response
Pseudobulbar affect, dysarthria, and dysphagia
Frontal-executive cognitive decline and apathy
REM sleep behavior disorder and severe sleep fragmentation

Risk Factors

Age over 60
Male sex (slight predominance)
MAPT H1 haplotype
Rare familial cases with MAPT mutations
Possible environmental exposures (poorly defined)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent falls without an identified cause in older adults
  • Atypical parkinsonism with poor levodopa response
  • Early eye movement abnormalities or dysphagia
  • Rapidly progressive parkinsonism with cognitive change

Treatment Methods

01
Levodopa trial — usually limited but sometimes partial response in PSP-parkinsonism
02
Symptomatic medications for sialorrhea, dystonia, depression, and sleep disorders
03
Multidisciplinary rehabilitation with physical, occupational, and speech therapy and falls-prevention strategies
04
Swallowing assessment, dietary modifications, and consideration of percutaneous endoscopic gastrostomy in severe dysphagia
05
Advance care planning, caregiver support, and palliative care in advanced disease

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.