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Progressive supranuclear palsy

  • Sx

    • imbalance, falls
    • apathy
    • slurred speech, dysphagia
    • vertical gaze palsy
    • gait abnormality
  • HPI/ROS

    • onset
    • progression
    • hallucinations
    • apathy
    • personality changes
  • Px

    • mental status, cognition
    • vertical gaze palsy
    • rigidity
    • check CNs
    • gait
  • Labs

    • this is a clinical diagnosis.
    • MRI or CT to rule out other possibilities
    • minimal response to levodopa (vs Parkinson's)
  • Tx

    • no effective therapy exists.
    • Options include: amantadine, zolpidem, idazoxan, amitriptyline
    • tx dysphagia with botox injection, methysergide

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