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Neurology  (Expert Forum)
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progressive supranuclear palsy
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progressive supranuclear palsy

by monica__0__0, Jul 08, 1997 12:00AM

    
      Re: progressive supranuclear palsy
    


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Posted by CCF Neuro MD on July 13, 1997 at 22:46:54:

In Reply to: progressive supranuclear palsy posted by monica on July 08, 1997 at 10:47:33:
  My father has recently been diagnosed with progressive supranuclear palsy.  I would like more information about this disease, i.e., prognosis, new treatments, any advise would be greatly appreciated.
==========================================================
Hello, Monica,
  Progressive supranuclear palsy (PSP) is usually a disease of the older population, with onset in the sixth and seventh decade of life.  The most common presenting symptoms are an unsteady gait with a tendency to fall, particularly backward, slurred speech, vision problems, and mental deficits. The most distinctive clinical feature is a specific eye finding so called vertical gaze palsy ( having trouble moving eyes up and down).  
  The diagnosis requires careful examination to rule out other diseases that share some of the features such as Parkinson's disease.  As far as what causes the disease, no one really knows.  Surprisingly, little has been added to the old description of iits pathology: certain nerve cell loss and degenerative changes.  
  Unfortunately, PSP is relentlessly progressive, with an average survival time of up to 6 years.  The usual cause of death is pneumonia.  What makes the disease real ugly is that the treatment is largely unrewarding.  Antiparkinsonian drugs have been used for some of the symptoms such as rigidity (stiffness).  However, the results have been inconsistent, to say the least.  More often, there is little or no response.  Antidepressants have been reported successful in some cases.
  Please realize it is very important to avoid aspiration.  The way of doing this is to alter diet regularly.  Eventually tube feeding needs to be considered.  Therefore, the supportive therapy is imperative in your father's long term care.  I would recommand you get him evaluated at a comprehensive care center where those issues can be addressed and followed.  If you have a chance to come to Cleveland, we will be happy to offer him such evaluation.  Please call (800) 223-2273 ext. 45559 or (216) 444-5559 for an appointment.  Good Luck.
  This information is provided for general medical education purposes only. Please consult your physician for the diagnostic and treatment of your specific medical condition.





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