What is Progressive Supranuclear Palsy

Progressive supranuclear palsy is a rare brain disorder that causes problems with walking, eye movement, and balance. It may also cause depression, memory loss, and changes in behavior.

Progressive supranuclear palsy happens when cells at the base of the brain gradually deteriorate. The condition gets worse with time. There is no cure for this condition.

What are the causes?

The cause of this condition not known. In some cases it may be caused by genes passed down through families.

What increases the risk?

You are more likely to develop this condition if:

• You are older than 60 years old.
• You are male.

What are the signs or symptoms?

Symptoms of this condition include:

• Unexplained falls, or loss of balance while walking.
• Walking that is stiff and awkward.
• Slow movements and stiff muscles.
• Inability to focus the eyes properly.
• Dementia that gets worse with time (progressive dementia).
• Difficulty swallowing and speaking.
• Changes in mood and behavior, such as:
  • Lack of feeling or emotion (apathy).
  • Irritability.
  • Sudden laughing or crying.
• Personality changes.

How is this diagnosed?

This condition is diagnosed based on your symptoms, especially:

• Poor balance.
• Vision problems.
• Slurred speech.
• Mental or behavioral changes.

You may also have tests to help rule out other causes of your symptoms. These include:

• Brain imaging tests such as an MRI or CT scan.
• A barium swallow study. In this study, X-rays of your digestive system are taken after you swallow the chemical barium. Barium makes the images clear.
• Memory tests, also called neuropsychological testing.

How is this treated?

There is no cure for this condition, but treatment can help with symptoms. Treatment may include:

• Medicines for Parkinson disease. These may help with slowness, stiffness, and balance problems.
• Antidepressant medicines to treat depression.
• Walking aids to prevent falls.
• Glasses with prisms to help with vision.
• A surgical procedure to place a feeding tube into your stomach (gastrostomy) if swallowing becomes very hard.

Treatment involves a team of health care providers. The team may include:

• A physical therapist. This person can help you identify a safe exercise program.
• A speech and language therapist. This person can teach you ways to swallow foods and liquids safely and how to speak more clearly.
• An occupational therapist. This person can teach you how to use walking aids and ways to make your home safe.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Use walking aids and prisms as told by your health care provider.
• Work closely with your health care team and follow their instructions.
• Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

• Cure PSP website: psp.org  
• National Institute of Neurological Disorders and Stroke: ninds.nih.gov  

Contact a health care provider if:

• You have chills or fever.
• Your symptoms are getting worse.
• You develop new symptoms.
• You are losing weight.
• You are choking while eating.
• You have a cough that will not go away.
• You have shortness of breath.
• You are anxious or depressed.
• You are not getting enough support at home.

Get help right away if:

• After eating or drinking you choke, cough, or have trouble breathing.
• You fall and hurt yourself.
• You no longer feel safe at home.

Summary

• Progressive supranuclear palsy is a rare brain disorder that causes problems with walking, eye movement, and balance. It may also cause depression, memory loss, and changes in behavior.
• There is no cure for this condition, but treatment can help relieve your symptoms.
• This condition is diagnosed based on your symptoms.
• Treatment for this condition may include medicines that are used to treat Parkinson disease and medicines that are used to treat other symptoms like depression. Other treatments involve various therapies that help with daily living.