20th July 2023

Progressive Supranuclear Palsy (PSP)

PSP is a rare progressive degenerative syndrome characterised by ataxia, vertical gaze palsy and cognitive impairment. It tends to be slightly later onset (60-70 years) than other similar syndromes. Common symptoms include ataxia, frontotemporal dementia, gaze palsy and hypokinesia. Some patients are also noted to have disinhibition and dysphagia. Often a patient complains of difficulty looking down and describes diplopia when reading. PSP is thought to be caused by the accumulation of tau proteins within the brain (described as tufts seen in astrocytes), particularly in the basal ganglia and brainstem. An MRI can be used to diagnose PSP by showing a ‘hummingbird’ and ‘Mickey Mouse’ sign. Management requires an MDT approach, with physio and occupational therapist input. There is currently no thorough research to strongly back medication use.