Progressive Supranuclear Palsy

Although similar cases were described without pathologic correlation, progressive supranuclear palsy (PSP) was first described in modern times and named as an entity by Steele, Richardson and Olszewski in 1964. In an excellent clinico-pathologic discussion, they noted a 'progressive brain disease featured by supranuclear ophthalmoplegia affecting chiefly vertical gaze, pseudobulbar palsy, dysarthria, dystonic rigidity of the neck and upper trunk, and other less constant cerebellar and pyramidal symptoms. Dementia has usually remained mild.' Only a few minor details have been noteworthy since then. There is however some variability in the progression and presenting symptoms of the condition. To get a better understanding of the course of the disease and the relative frequency of the different symptoms and findings, I have collated 329 cases reported in the literature as PSP. I will review the basic demographic data and the various information regarding the initial presentations. Other features of the disease a the physical examination will then be discussed including the oculomotor examination.