Progressive supranuclear palsy

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Central nervous system

Dementia-nuchal dystonia; Richardson-Steele-Olszewski syndrome; Palsy - progressive supranuclear

• Changes in expressions of the face
• Deeply lined face
• Difficulty moving the eyes or lack of control over the eyes
• Different size pupils
• Difficulty swallowing
• General slowness of movement (bradykinesia)
• Jaw or face jerks or spasms
• Loss of coordination, unsteady gait (walking pattern)
• Mild-to-moderate dementia
  • Difficulty using knowledge
  • Forgetfulness
  • Indifference (apathy)
  • Slowed thought processes
• Personality changes
• Repeated falls
• Slow or stiff movements
• Speech difficulties
  • Low voice volume
  • Poor ability to speak clearly (enunciate)
  • Slow speech
• Stiffness and rigid movement in the neck, middle of the body, arms, legs
• Tremor
• Vision difficulty -- unable to look up or down without bending the neck

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An exam of the nervous system (neurological examination) may show:

• Dementia that is getting worse
• Limited eye movements, especially up and down movements
• Normal vision, hearing, sensation, and voluntary control of movement
• Stiff and uncoordinated movements like those of Parkinson's disease

The health care provider may do tests to rule out other diseases. Magnetic resonance imaging (MRI) might show shrinking of the brainstem.

Review Date: 05/05/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).