What is Progressive Supranuclear Palsy?

Progressive supranuclear palsy is the deterioration of brain cells that manage coordination, balance, body control, mental ability, and other critical functions that impact health and quality of life. This condition is also referred to as Steele-Richardson-Olszewski syndrome.

Each part of the condition’s name describes the nature of the disease. Progressive means that the conditions gets worse across time. Supranuclear indicates the areas of your brain affected by the condition. Palsy indicates that the condition weakens muscles.

Signs and Symptoms

Progressive supranuclear palsy worsens over time. The symptoms often intensify by stage of the condition.

Progressive supranuclear palsy symptoms:

• Trouble sleeping
• Stiffness
• Speech problems
• Movement issues
• Difficulty swallowing
• Eye movement issues
• Vision problems
• Anxiety
• Light sensitivity
• Depression
• Falling
• Impulsiveness
• Anger
• Uncontrolled blinking
• Memory issues
• Abnormal facial expressions
• Reduced interest in activities

Three common symptoms of progressive supranuclear palsy are difficulty with eye movement, vision, and balance.

Causes

Your doctor will discuss the latest information about progressive supranuclear palsy causes with you.

Information about causation might include:

• Exact cause unknown—There is no known exact cause of the condition. The symptoms of the condition result from deteriorated brain cells.
• Tau protein—Researchers have found some correlation between excess tau protein and progressive supranuclear palsy.
• Genetics—There is no clear link between family genetics and the disease. However, in some cases, genetics appear to possibly play a role in the development of the condition.

Risk Factors

Age is the only recognized risk factor for progressive supranuclear palsy. The condition tends to affect people 60 years and older. Developing the disease under the age of 40 is exceedingly rare.

Researchers have studied other potential progressive supranuclear palsy risk factors but did not identify any definitive environmental factors. There is a correlation between high levels of tau protein and the disease, but a direct link is not clear.

Diagnosis

A progressive supranuclear palsy diagnosis is sometimes complicated because the condition’s symptoms mimic the symptoms of other disorders such as a stroke or Parkinson’s disease. Your doctor will likely base a diagnosis on the results of a routine medical exam and imaging tests.

Diagnostic process:

• Medical exam—Your doctor will ask about your general health, medical history, and symptoms. Your doctor may rule out Parkinson’s disease if you show no signs of shaking, if you experience trouble controlling your eye movements, and if you do not respond to medication for Parkinson’s disease.
• Imaging tests—Your doctor might use magnetic resonance imaging (MRI) or a positron emission tomography (PET) scan to look for size reduction in areas of brain related to progressive supranuclear palsy.

Treatment

There is no cure for progressive supranuclear palsy. Therefore, treatments focus on symptom reduction and management.

Progressive supranuclear palsy treatment:

• Physical Therapy—Physical and occupational therapy can help improve your coordination and balance.
• Eyeglasses—Glasses with prism or bifocal lenses can reduce vision issues.
• Medication—Some medications can temporarily help with muscle movements.
• OnabotulinumtoxinA —Small doses of this chemical can reduce eyelid spasms.
• Speech therapy—This therapy can help reduce speech problems.
• Swallowing therapy—This therapy can help reduce difficulty with swallowing.

Progressive supranuclear palsy prognosis is difficult to predict and varies by individual. You can enhance your treatment by engaging in lifestyle changes such as using eye drops, installing grip bars at home to prevent falls, and surrounding yourself with a caring support system.

Complications

There are several common complications of progressive supranuclear palsy.

Complications might include:

• Physical limitations—You may want to use a weighted walker and avoid stairs. As your condition progresses, you may experience more limitations to physical activities.
• Emotional impulsiveness—It is common to suddenly feel angry, cry, or laugh without any clear reason.
• Speech issues—You may find it difficult to communicate with others.
• Vision issues—You may experience problems with your sight.

If you or a loved one experience any of the signs of progressive supranuclear palsy prognosis, a neurologist at Baptist Health may be able to help.