Overview
Progressive supranuclear palsy is a rare brain disorder that leads to serious problems with walking, balance, eye movements, and later with swallowing. It results from the deterioration of cells in areas of the brain that control body movement, coordination, thinking, and other important functions. The condition worsens over time and can lead to life-threatening complications. There is no cure for progressive supranuclear palsy, so treatment focuses on managing the signs and symptoms. Common symptoms include loss of balance while walking, difficulty with eye movements, stiffness, falling, slow speech, problems with swallowing, sensitivity to bright light, sleep disturbances, loss of interest in pleasurable activities, impulsive behavior, and difficulties with reasoning, problem-solving, and decision-making. The cause of progressive supranuclear palsy is not known, and it is not inherited in most cases. The only known risk factor is age, as the condition typically affects people in their late 60s and 70s.
Understanding the disease
Symptoms
The characteristic symptoms of progressive supranuclear palsy include a loss of balance while walking, difficulty aiming eyes properly, stiffness, awkward movements, falling, slow or slurred speech, problems with swallowing, sensitivity to bright light, sleep disturbances, loss of interest in pleasurable activities, impulsive behavior, and a surprised or frightened facial expression.
Risk Factors
The only proven risk factor for progressive supranuclear palsy is age. The condition typically affects people in their late 60s and 70s. It's virtually unknown in people under the age of 40.
Question: What are the complications that can arise from progressive supranuclear palsy? Complications of progressive supranuclear palsy result primarily from slow and difficult muscle movements. These complications may include:
- Falling, which could lead to head injuries, fractures, and other injuries
- Difficulty focusing your eyes, which also can lead to injuries
- Difficulty sleeping, which can lead to a feeling of tiredness and excessive daytime sleeping
- Difficulty looking at bright lights
- Problems swallowing, which can lead to choking or inhaling food or liquid into your airway (aspiration) Additionally, other complications may include sensitivity to bright light, sleep disturbances, loss of interest in pleasurable activities, impulsive behavior, difficulties with reasoning, problem-solving, and decision-making, depression and anxiety, a surprised or frightened facial expression, resulting from rigid facial muscles, dizziness.
Development
Progressive supranuclear palsy (PSP) is a rare brain disorder that affects movement, balance, eye movements, and later, swallowing. It results from the degeneration of cells in specific areas of the brain that control body movement, coordination, and other important functions. The exact cause of PSP is not known, but researchers have found excess amounts of a protein called tau in the affected brain cells. This accumulation of tau is also observed in other neurodegenerative disorders, such as Alzheimer's disease. PSP symptoms develop gradually over time and worsen with age. The initial symptoms may include a loss of balance while walking, falling backward, difficulty aiming the eyes properly, blurring or double vision, and slow or slurred speech. As the condition progresses, additional symptoms may resemble those of Parkinson's disease and dementia, such as stiffness, awkward movements, slow speech, swallowing problems, sensitivity to bright light, sleep disturbances, and a loss of interest in pleasurable activities. PSP is not inherited in most cases, and the risk factor is primarily age, affecting people in their late 60s and 70s. There is no cure for PSP, and treatment focuses on managing the symptoms and preventing complications.
Assessment and Diagnosis
Triage
You should see a doctor if you experience any of the signs and symptoms listed above, which may indicate progressive supranuclear palsy. As the condition worsens, it can lead to life-threatening complications, so early diagnosis and intervention are important.
Diagnosis
To diagnose progressive supranuclear palsy, your doctor may consider several factors. Since the symptoms of progressive supranuclear palsy are similar to those of Parkinson's disease, your doctor may suspect progressive supranuclear palsy if you don't have tremors, have a lot of unexplained falls, have little or no response to Parkinson's medications, and have difficulty moving your eyes, particularly downward. Your doctor may recommend an MRI to determine if you have shrinkage in specific regions of the brain associated with progressive supranuclear palsy. An MRI can also help to exclude disorders that may mimic progressive supranuclear palsy, such as a stroke. A positron emission tomography (PET) scan may also be recommended to check for early signs of changes in the brain that may not appear on an MRI.
Management and Treatment
Complications
Complications of progressive supranuclear palsy result primarily from slow and difficult muscle movements. These complications may include:
- Falling, which could lead to head injuries, fractures, and other injuries.
- Difficulty focusing your eyes, which also can lead to injuries.
- Difficulty sleeping, which can lead to a feeling of tiredness and excessive daytime sleeping.
- Difficulty looking at bright lights.
- Problems swallowing, which can lead to choking or inhaling food or liquid into your airway (aspiration).
Home Remedies
It's important to consult with a healthcare professional for proper diagnosis and treatment of progressive supranuclear palsy. They can provide guidance on managing symptoms and addressing any complications that may arise.
Treatment
Treatment for progressive supranuclear palsy (PSP) is focused on managing symptoms and improving quality of life. There is no cure for PSP, but various treatment options are available. These include:
- Parkinson's disease medications: These medications can help increase levels of a brain chemical involved in smooth, controlled muscle movements. However, their effectiveness is limited and usually temporary, lasting about 2 to 3 years in most patients.
- OnabotulinumtoxinA (Botox): Injecting Botox into the muscles around the eyes may help improve eyelid spasms.
- Speech and swallowing evaluations: These evaluations can help you learn alternative communication methods and safer swallowing techniques.
- Physical and occupational therapy: Therapy can help with balance, facial exercises, and gait and balance training to address symptoms of PSP.
- Research: Researchers are working on developing new medications to treat PSP, including therapies that may block the formation of tau or help destroy tau. Lifestyle modifications at home can also help minimize the effects of PSP. These include using eye drops for dry eyes, installing grab bars for safety, using a weighted walker, and avoiding stairs. Remember to consult with a healthcare professional, such as a neurologist, for personalized advice and treatment options.
Preparing for medical consultation
To prepare for an appointment for progressive supranuclear palsy, you should:
- Write down your symptoms, including any that may seem unrelated to the condition.
- Make a list of all your medications, vitamins, and supplements.
- Write down your key medical information, including other conditions.
- List any recent changes or stressors in your life.
- Compile a list of questions to ask your doctor.
- Consider bringing a relative or friend to accompany you for support and to help remember the doctor's advice. Remember to discuss your feelings and concerns about living with progressive supranuclear palsy with your doctor or a counselor, particularly for caregivers who may find the care-giving process challenging physically and emotionally.