Progressive Supranuclear Palsy

Nervous System & Special Senses


Clinicals - History

Fact Explanation
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Progressive supranuclear palsy (PSP) is an adult-onset, rapidly progressive neurodegenerative disease characterized by intracerebral aggregation of tau protein. A definite diagnosis of PSP requires a neuropathological examination.\n\nPSP occurs in 5-6% of patients with parkinsonism. Most patients are between 63 and 66 years old and have a mean survival of 5 to 9 years. Males are more commonly affected than females.\n\nPSP is the most common \u201cParkinson-plus\u201d syndrome. The cause of PSP is not known."}]}
{"ops":[{"insert":"History of falls"},{"insert":"\n"}]}
{"ops":[{"insert":"Progressive supranuclear palsy is characterized by early frequent falls, particularly falling backwards.\n\nFalls are multifactorial and may result from axial rigidity, bradykinesia, freezing, reduced\/absent postural reflex, visual-vestibular deficits, or decreased insight due to frontal lobe disturbance."}]}
{"ops":[{"insert":"Unsteady gait"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may show a clumsy, slow and unsteady gait (\u0022drunken sailor gait\u0022)."}]}
{"ops":[{"insert":"Visual symptoms"},{"insert":"\n"}]}
{"ops":[{"insert":"Visual symptoms include blurred vision, photosensitivity, diplopia, and difficulty reading. These result from the inability to look down and from convergence insufficiency."}]}
{"ops":[{"insert":"Behavioral changes"},{"insert":"\n"}]}
{"ops":[{"insert":"Behavioral changes include emotional withdrawal, apathy, depression, disinhibition, dysphoria, anxiety, irritability, and agitation. Pseudobulbar symptoms (laughing or crying incongruous with mood) can also occur."}]}
{"ops":[{"insert":"Parkinsonism"},{"insert":"\n"}]}
{"ops":[{"insert":"Parkinsonism features associated with progressive supranuclear palsy include asymmetric tremor, bradykinesia, axial rigidity, and early gait and postural instability."}]}
{"ops":[{"insert":"Dysphagia\/dysarthria"},{"insert":"\n"}]}
{"ops":[{"insert":"Dysarthria and dysphagia are present early in the disease course. These are due to pseudobulbar palsy."}]}
{"ops":[{"insert":"Cognitive decline"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients show progressive cognitive decline, marked by slowed processing, reduced verbal fluency, and executive dysfunction. This results from progressive frontal subcortical dementia."}]}
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Progressive supranuclear palsy (PSP) is an adult-onset, rapidly progressive neurodegenerative disease characterized by intracerebral aggregation of tau protein. A definite diagnosis of PSP requires a neuropathological examination.\n\nPSP occurs in 5-6% of patients with parkinsonism. Most patients are between 63 and 66 years old and have a mean survival of 5 to 9 years. Males are more commonly affected than females.\n\nPSP is the most common \u201cParkinson-plus\u201d syndrome. The cause of PSP is not known."}]}
{"ops":[{"insert":"History of falls"},{"insert":"\n"}]}
{"ops":[{"insert":"Progressive supranuclear palsy is characterized by early frequent falls, particularly falling backwards.\n\nFalls are multifactorial and may result from axial rigidity, bradykinesia, freezing, reduced\/absent postural reflex, visual-vestibular deficits, or decreased insight due to frontal lobe disturbance."}]}
{"ops":[{"insert":"Unsteady gait"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may show a clumsy, slow and unsteady gait (\u0022drunken sailor gait\u0022)."}]}
{"ops":[{"insert":"Visual symptoms"},{"insert":"\n"}]}
{"ops":[{"insert":"Visual symptoms include blurred vision, photosensitivity, diplopia, and difficulty reading. These result from the inability to look down and from convergence insufficiency."}]}
{"ops":[{"insert":"Behavioral changes"},{"insert":"\n"}]}
{"ops":[{"insert":"Behavioral changes include emotional withdrawal, apathy, depression, disinhibition, dysphoria, anxiety, irritability, and agitation. Pseudobulbar symptoms (laughing or crying incongruous with mood) can also occur."}]}
{"ops":[{"insert":"Parkinsonism"},{"insert":"\n"}]}
{"ops":[{"insert":"Parkinsonism features associated with progressive supranuclear palsy include asymmetric tremor, bradykinesia, axial rigidity, and early gait and postural instability."}]}
{"ops":[{"insert":"Dysphagia\/dysarthria"},{"insert":"\n"}]}
{"ops":[{"insert":"Dysarthria and dysphagia are present early in the disease course. These are due to pseudobulbar palsy."}]}
{"ops":[{"insert":"Cognitive decline"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients show progressive cognitive decline, marked by slowed processing, reduced verbal fluency, and executive dysfunction. This results from progressive frontal subcortical dementia."}]}

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