Learn About Progressive Supranuclear Palsy
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:
- Loss of balance, repeated falls
- Lunging forward when moving, or fast walking
- Bumping into objects or people
- Changes in expressions of the face
- Deeply lined face
- Eye and vision problems such as different sized pupils, difficulty moving the eyes (supranuclear ophthalmoplegia), lack of control over the eyes, problems keeping the eyes open
- Difficulty swallowing
- Tremors, jaw or face jerks or spasms
- Mild-to-moderate dementia
- Personality changes
- Slow or stiff movements
- Speech difficulties, such as low voice volume, not able to say words clearly, slow speech
- Stiffness and rigid movement in the neck, middle of the body, arms, and legs
The goal of treatment is to control symptoms. There is no known cure for PSP.
Medicines such as levodopa (combined with carbidopa) may be tried. These medicines 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.
Johns Hopkins Outpatient Center
Dr. Alexander Pantelyat cares for patients with movement disorders such as Parkinson's disease and related syndromes, essential tremor, dystonia, chorea and normal pressure hydrocephalus. He also provides botulinum toxin injections for movement disorders and is involved in deep brain stimulation programming and intraoperative neurophysiological monitoring.His research explores atypical parkinsonian disorders, such as dementia with Lewy bodies, progressive supranuclear palsy, corticobasal syndrome/degeneration and multiple system atrophy; cognitive aspects of movement disorders; and music-based rehabilitation of neurodegenerative diseases.Dr. Pantelyat earned his medical degree from Temple University School of Medicine in Philadelphia, where he was elected a member of the Alpha Omega Alpha Honor Medical Society and received the Matthew T. Moore Prize in Neurology. He completed his residency training in Neurology at the University of Pennsylvania in Philadelphia, and a fellowship in movement disorders at the University of Pennsylvania/Philadelphia VA Medical Center. As part of his fellowship, Dr. Pantelyat also completed the Clinical Research Certificate Program at the Center for Clinical Epidemiology and Biostatistics. He is a 2013 American Academy of Neurology Palatucci Advocacy Leader and grant recipient. Dr. Pantelyat is rated as an Elite provider by MediFind in the treatment of Progressive Supranuclear Palsy. His top areas of expertise are Progressive Supranuclear Palsy, Progressive Supranuclear Palsy Atypical, Supranuclear Ophthalmoplegia, and Movement Disorders.
Matthias Brendel practices in Munich, Germany. Mr. Brendel is rated as an Elite expert by MediFind in the treatment of Progressive Supranuclear Palsy. His top areas of expertise are Progressive Supranuclear Palsy, Progressive Supranuclear Palsy Atypical, Supranuclear Ophthalmoplegia, and Brown Syndrome.
Reading Hospital Neurology Suite 104
. Dr. Lamichhane is rated as a Distinguished provider by MediFind in the treatment of Progressive Supranuclear Palsy. His top areas of expertise are Movement Disorders, Parkinson's Disease, Secondary Parkinsonism, and Supranuclear Ophthalmoplegia.
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 medicines are being studied to treat this condition.
Complications of PSP include:
- Blood clot in veins (deep vein thrombosis) due to limited movement
- Injury from falling
- Lack of control over vision
- Loss of brain functions over time
- Pneumonia due to trouble swallowing
- Poor nutrition (malnutrition)
- Side effects from medicines
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.
Summary: In this study the investigators would like to investigate the degree of damage of the synapses, an important part of the neurons vital for the communications between neurons, in Multiple System Atrophy (MSA), and pathology related to abnormal accumulation of a protein named tau, in Progressive Supranuclear Palsy (PSP).
Summary: The goals of this study are: 1) to identify biomarkers using neuroimaging that are associated with progression rate using statistical methods, and 2) to identify biomarkers that are associated with the differential diagnosis of Parkinson's disease and atypical parkinsonism.
Published Date: June 13, 2024
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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.
National Institute of Neurological Disorders and Stroke website. Progressive supranuclear palsy (PSP). www.ninds.nih.gov/health-information/disorders/progressive-supranuclear-palsy-psp. Updated November 28, 2023. Accessed June 28, 2024.
Rowe JB, Holland N, Rittman T. Progressive supranuclear palsy: diagnosis and management. Pract Neurol. 2021;21(5):376-383. PMID: 34215700 pubmed.ncbi.nlm.nih.gov/34215700/.