Progressive Supranuclear Palsy

What is Progressive Supranuclear Palsy?

Progressive Supranuclear Palsy (PSP) is a rare, progressive neurodegenerative disease that affects movement, balance, vision, speech and cognitive abilities. The disease causes gradual damage to the areas of the brain that control movement and thinking. As the disease progresses, symptoms worsen and increasingly impact daily activities.

It is sometimes mistaken for Parkinson’s Disease as the conditions share similar movement symptoms. But, PSP has some distinctive features, specifically problems with balance, frequent falls and difficulty controlling eye movements.

Who is Affected?

PSP is rare, impacts men and women at the same rate and typically occurs with no known family history. It most commonly impacts older adults (60+).

What are the Causes and Risk Factors?

PSP is caused by an abnormal buildup of tau protein in certain brain cells. This buildup damages and destroys nerve cells, which causes the problems with movement, vision, speech and thinking.

It is unknown what causes the initial abnormal tau buildup in the brain cells.

Who is Most at Risk?

The disease is rare, and there is no known genetic cause. Older adults, especially those over 60, are most at risk.

There is no known way to reduce the risk of developing PSP.

What are the Signs & Symptoms?

Symptoms of PSP develop gradually and worsen over time. Early symptoms often involve balance and walking challenges.

Movement-Related Symptoms

• Frequent falls (often backwards)
• Stiffness or slowness of movement
• Difficulty walking or maintaining balance

Vision and Eye-Related Symptoms

• Difficulty moving the eyes up and down
• Blurred or double vision
• Jerky or slowed eye movements

Speech and Swallowing Symptoms

• Slurred or slow speech
• Changes in speech volume or rhythm
• Difficulty swallowing

Cognitive and Behavioral Symptoms (usually later in the disease process)

• Difficulty with decision-making or judgement
• Changes in personality or behavior
• Apathy or reduced motivation
• Problems with thinking or communication

How is PSP Diagnosed?

There is no one test that can definitively diagnose PSP. The diagnosis will be based on a combination of assessments that may include medical history, neurological examination, evaluation of symptoms, cognitive and speech assessments, eye exams and other tests to rule out other diagnoses.

What Tests are Used?

• Neurological examination
• Assessments of eye movement and balance
• Speech evaluations
• Cognitive assessments
• Brian imaging (such as MRI or CT)
• Tests to rule out other neurological conditions

How is Progressive Supranuclear Palsy Treated?

There is currently no cure for PSP, and there are no treatments proven to slow the progression of the disease. Treatment focuses on symptom management and maintaining quality of life.

Lifestyle

• Fall prevention strategies
• Establishing daily routines
• Modifying home environment for safety

Devices

• Mobility aids
• Supportive devices to reduce fall risk

Medical

• Medications to manage stiffness and movement-symptoms
• Medications to address mood
• Medications to manage sleep issue

Surgical

• There is no surgical treatment for PSP

Other

• Speech therapy to address communication and swallowing-issues
• Physical therapy to support balance and mobility
• Occupational therapy to assist with daily activities
• Caregiver education and support services

When to See Your Doctor

You should talk to your doctor if you or your loved one experiences frequent falls, balance problems or increasing difficulties with speech or swallowing.

When to Seek Emergency Medical Care

Seek emergency medical attention if symptoms worsen quickly or if there are serious swallowing problems, injuries from falls or sudden changes in alertness or consciousness.

Frequent falls, worsening balance or increasing difficulty with speech or swallowing are not symptoms that should be ignored. Talk with your doctor so they can evaluate your symptoms and determine the next steps.

Visit Understanding Memory to learn more about the many things than can impact memory.

To learn more and connect with support, visit Riverside Health’s Martha W. Goodson Center.