Progressive Supranuclear Palsy (PSP) is a rare, progressive brain disorder that affects movement, balance, eye control, speech, and thinking. It is often mistaken for Parkinson’s disease in the early stages but has distinct features and a more rapid progression.
PSP results from damage to brain cells caused by the buildup of a protein called tau. This affects areas of the brain that control movement, coordination, and cognition.
Common Symptoms of PSP
- Early Falls – frequent, unexpected backward falls often within the first year
- Eye Movement Difficulty – especially trouble looking up or down
- Slurred or Slow Speech (Dysarthria)
- Swallowing Difficulties (Dysphagia)
- Facial Rigidity – fixed facial expression or “startled” look
- Cognitive Changes – slowed thinking, mood changes, apathy
- Stiffness and Slowness – similar to Parkinson’s, but less tremor
- Poor Balance and Gait Problems
Diagnosis
There is no single test for PSP, but diagnosis is made through:
- Detailed Neurological Exam – evaluating eye movements, balance, stiffness, and cognitive changes
- MRI Brain Imaging – may show atrophy in specific brain regions (e.g., midbrain)
- Ruling Out Other Conditions – including Parkinson’s disease, Alzheimer’s, and normal pressure hydrocephalus
- Response to Parkinson’s Medications – PSP typically does not respond well to levodopa
Treatment Options
There is no cure for PSP, but symptoms can be managed with a personalized care plan.
1. Medication Options
- Levodopa/Carbidopa: May offer mild improvement in stiffness or slowness (often limited)
- Amantadine: May help with movement or alertness in some cases
- SSRIs (e.g., sertraline): Can help with mood, apathy, or depression
- Botulinum Toxin (Botox): May help with eye or neck tightness (e.g., dystonia)
Medication response is often limited, so supportive therapy is essential.
2. Supportive Therapies
- Physical Therapy: Focus on fall prevention, walking aids, and core strength
- Occupational Therapy: Assist with daily tasks and home modifications
- Speech Therapy: Supports clear speech and safe swallowing
- Nutritional Counseling: Helps prevent weight loss and aspiration
- Eyewear Adaptations: Prism glasses may assist with downward gaze
3. Assistive Devices
- Weighted walkers or rollators with brakes
- Shower chairs, grab bars, and raised toilet seats
- Communication tools for speech changes
Planning Ahead
Living with PSP requires a team-based approach to care and regular support. Because PSP is progressive, we encourage:
- Early discussions about goals of care
- Advanced directives and medical power of attorney
- Connection to support groups and caregiver resources
At NeuroMotion, we provide:
- Virtual care with movement disorder specialists
- Customized treatment and safety plans
- Regular symptom monitoring and medication review
- Referrals to therapy professionals and home safety resources
- Compassionate support for both patients and caregivers
If you or a loved one has been diagnosed with PSP, don’t face it alone. Our NeuroMotion Telehealth team provides expert care, education, and guidance—all from the comfort of your home.