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Progressive supranuclear palsy

Alternative Names: Dementia-nuchal dystonia; Richardson-Steele-Olszewski syndrome; Palsy - progressive supranuclear Symptoms: Repeated falls Loss of coordination, unsteady gait (walking pattern) Stiffness and rigid movement in the neck, trunk, arms, legs Difficulty swallowing May have a tremor Pain or difficulty with bending the neck up or down Slow or stiff movements Vision difficulty -- unable to look up or down without bending the neck Changes in facial expression "Masking," reduced expression Deeply lined face Jaw or face jerks or spasms Eyes, pupils different size Eye movements, uncontrollable Generalized slowness of all movement (bradykinesia) with strength relatively preserved Speech difficulties Slow speech Poor enunciation Low voice volume Dementia, mild Forgetfulness Slowed thought processes Apathy (indifference) Difficulty manipulating knowledge Personality changes, vague and mild Signs and tests: A neurological examination may show Parkinsonian movements with typical stiffness and lack of coordination. Dementia is mild. Eye movements are limited, particularly vertical movements. However, vision, hearing, sensation, and voluntary control of movement remain intact. Text Continues Below Tests may be done to rule out other diseases. An MRI might show shrinking of the brainstem.

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