Parkinson's Disease: Progressive Supranuclear Palsy
Introduction
Progressive supranuclear palsy, or PSP, is a rare neurodegenerative disease that is often misdiagnosed as Parkinson's disease because it carries similar symptoms. Because of its rarity, PSP is mostly unknown by the general public.
What Causes PSP?
PSP develops because of the deterioration of brain cells in a few small, but very important areas at the base of the brain. The most important affected area is the substantia nigra. When this area of the brain is affected by the disease, a lot of the palsy's symptoms become more visible. Research is still being conducted as to why the brain cells degenerate.
What Are the Early Symptoms of PSP?
The beginning stages of PSP include the inability to walk, falling spells and stiffness. Falls experienced by a PSP patient are often described as having a state of dizziness, prior to actually falling. This dizziness description is sometimes misdiagnosed as an inner ear problem or a hardening of the arteries that are blocking blood flow to the brain.
Other common symptoms of PSP include:
- Forgetfulness
- Change in personality
- Loss of interest in usual socializing with family and friends
What Are Some of the Later Symptoms of PSP?
The word "progressive" was included in the palsy's name because symptoms typically progressively worsen for a patient. After seven to nine years, PSP becomes more difficult to deal with. The disease usually causes physical imbalance and stiffness of the body to grow worse, making walking very difficult or sometimes impossible.
Problems with eyesight also occur in the later stages of PSP. Usually visual problems can become as much of an issue as impaired walking for the patient. Eyesight is most affected by the difficulty to aim the eye properly, making reading very hard. Another eyesight problem that is sometimes encountered is the inability to maintain visual contact with another person during conversation. PSP can also cause "tunnel vision", which sometimes causes problems while a person is trying to drive a car.
Does PSP Affect a Person Mentally?
Most PSP patients eventually experience a mild to moderate degree of mental problems. With PSP, dementia, or mental confusion, causes a person to have a slowed thinking process or difficulty synthesizing ideas. The slowing of thoughts and thinking makes it hard for the person to hold a conversation with others or to analyze problems.
How Is PSP Treated?
There is a range of medication that can help curb PSP's symptoms.
Sinemet is sometimes used because it contains levodopa, which aids in controlling shakiness and tremors.
Anti-depressants are often suggested by physicians, along with sleeping pills, to help PSP patients who are experiencing sleep problems. Many drugs being developed to treat other neurological disorders are also being utilized to help treat PSP.
Is There a Cure for PSP?
There is no cure for PSP. Attention for a physician and family of a PSP patient should be focused on keeping the person comfortable and creating the best quality of life possible.
Reviewed by the doctors at The Cleveland Clinic Neuroscience Center.
Edited by Charlotte E. Grayson, MD, WebMD, March 2004.
Portions of this page © The Cleveland Clinic 2000-2005
Last Editorial Review: 1/31/2005 7:58:44 AM
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