Progressive supranuclear palsy (PSP) is a movement disorder that occurs from damage to certain nerve cells in the brain.
Dementia - nuchal dystonia; Richardson-Steele-Olszewski syndrome; Palsy - progressive supranuclear
PSP is a condition that causes symptoms similar to those of Parkinson disease.
It involves damage to many cells of the brain. Many areas are affected, including the part of the brainstem where cells that control eye movement are located. The area of the brain that controls steadiness when you walk is also affected. The frontal lobes of the brain are also affected, leading to personality changes.
The cause of the damage to the brain cells is unknown. PSP gets worse over time.
People with PSP have deposits in brain tissues that look like those found in people with Alzheimer disease. There is a loss of tissue in most areas of the brain and in some parts of the spinal cord.
The disorder is most often seen in people over 60 years old, and is somewhat more common in men.
Symptoms may include any of the following:
An exam of the nervous system (neurologic examination) may show:
The health care provider may do the following tests to rule out other diseases:
The goal of treatment is to control symptoms. There is no known cure for PSP.
Medicines such as levodopa may be tried. These drugs raise the level of a brain chemical called dopamine. Dopamine is involved in the control of movement. The medicines may reduce some symptoms, such as rigid limbs or slow movements for a time. But they are usually not as effective as they are for Parkinson disease.
Many people with PSP will eventually need around-the-clock care and monitoring as they lose brain functions.
Treatment sometimes can reduce symptoms for a while, but the condition will get worse. Brain function will decline over time. Death commonly occurs in 5 to 7 years.
Newer drugs are being studied to treat this condition.
Complications of PSP include:
Contact your provider if you often fall, and if you have a stiff neck/body, and vision problems.
Also, call if a loved one has been diagnosed with PSP and the condition has declined so much that you can no longer care for the person at home.
Jankovic J. Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier;2022:chap 96.
Ling H. Clinical approach to progressive supranuclear palsy. J Mov Disord. 2016;9(1):3-13. PMID: 26828211 .
National Institute of Neurological Disorders website. Progressive supranuclear palsy (PSP). . Updated March 8, 2023. Accessed May 3, 2023.
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