Progressive Supranuclear Palsy

Progressive supranuclear palsy (PSP) is a rare and chronic neurodegenerative disorder that damages certain areas of your brain. It affects how you walk, think, swallow and move your eyes. It may also cause other symptoms. PSP is also known as Steele-Richardson-Olszewski syndrome.

“Progressive” means that the symptoms get worse over time from the underlying neurodegenerative condition. “Supranuclear” and “palsy” together mean the inability to move your eyes, as “supranuclear” means that the damage is located above the eye-moving centers (nuclei) in your brain. “Palsy” means weakness or difficulty using your muscles.

PSP may closely resembles Parkinson’s disease, especially early on in its course. Experts consider it an atypical parkinsonian syndrome (or Parkinson-plus disorder). Healthcare providers often misdiagnose PSP as Parkinson’s disease, especially in the early stages of the condition. But PSP progresses faster than Parkinson’s disease.

The condition most commonly affects people over the age of 60. It very rarely develops before the age of 40.

What are the types of progressive supranuclear palsy (PSP)?

There are four different types, or phenotypes, of PSP. They all share similar symptoms, but there are some unique differences. The two most common types are Richardson syndrome and PD-like variant (PSP-P), which means a Parkinson’s disease-like variant. Together, they make up 75% of PSP cases.

Richardson syndrome has many symptoms, some of which include:

• Issues with walking and balance.
• Abnormal speech.
• Memory and thinking problems.
• Difficulty controlling eye movement (especially looking down).
• A wide-eyed, staring facial expression.

PD-like variant (PSP-P) has the same symptoms as Richardson syndrome, but more closely resembles Parkinson’s disease. A tremor (an involuntary muscle contraction that leads to shaking) is the main symptom (instead of balance problems and behavioral changes). PSP-parkinsonism may respond better to antiparkinsonian medications than other types of PSP, at least for some time.

The other two phenotypes include:

• Corticobasal syndrome.
• Pure akinesia and gait freezing.

How common is PSP?

PSP is rare. Around 5 people out of every 100,000 have it. About 1 per 100,000 people get diagnosed each year.