March 2023

Read about progressive supranuclear palsy and how we can help.

Progressive supranuclear palsy, also known as Steele-Richardson-Olszewski syndrome, is an uncommon brain disorder that causes serious problems with walking, balance, eye movements, and later swallowing. The disorder results from deterioration of cells in areas of your brain that control body movement, coordination, thinking and other important functions. PSP worsens over time and can lead to life-threatening complications, such as pneumonia and swallowing problems. There is no cure for progressive supranuclear palsy, so treatment focuses on managing the signs and symptoms.

What are symptoms of PSP?

Signs and symptoms of progressive supranuclear palsy include:

• Loss of balance while walking. A tendency to fall backward can occur very early in the disease.

• Inability to aim your eyes properly. You may not be able to look downward or experience blurriness and double vision. This difficulty with focusing the eyes can make some people spill food or appear disinterested in conversation because of poor eye contact.

Additional signs and symptoms of PSP vary and may mimic those of Parkinson's disease and dementia. They generally get worse over time and may include:

• Stiffness, especially of the neck, and awkward movements

• Falling, especially falling backwards

• Slow or slurred speech

• Problems with swallowing, which may cause gagging or choking

• Sensitivity to bright light

• Sleep disturbances

• Loss of interest in pleasurable activities

• Impulsive behavior, such as laughing or crying for no reason
   

What causes PSP?

The cause of progressive supranuclear palsy is unknown. The signs and symptoms of this disorder result from deterioration of cells in areas of your brain, especially those that help you control body movements and thinking. Researchers have found that the deteriorating brain cells of people with PSP have excess amounts of a protein called tau. It is also rare that PSP occurs within a family.

How is PSP Diagnosed?

Progressive supranuclear palsy can be difficult to diagnose because signs and symptoms are similar to those of Parkinson's disease. Your doctor may suspect that you have PSP rather than Parkinson's disease if you:

• Do not have tremors

• Are having a lot of unexplained falls

• Have little or no response to Parkinson's medications

• Have difficulty moving your eyes, particularly downward

How is PSP Treated?

There is no cure for progressive supranuclear palsy, but treatments are available to help ease symptoms of the disorder including:

• Parkinson's disease medications increase levels of the brain's chemicals involved in smooth, controlled muscle movements. The effectiveness of these medications are limited and usually temporary.

• Botox may be injected in small doses into the muscles around your eyes. Botox blocks the chemical signals that cause muscles to contract, which can improve eyelid spasms.

• Eyeglasses with bifocal or prism lenses may help ease problems with looking downward. Prism lenses allow people with PSP to see downward without moving their eyes down.

• Speech and swallowing evaluations can help you learn about alternative means to communicate and safer swallowing techniques.

Medication to treat progressive supranuclear palsy are being developed by researchers, including therapies that may block the formation of tau or help to destroy tau.

How We Can Help