The early symptoms of progressive supranuclear
palsy (PSP) are often attributed to the aging process. In many cases, after a
few months, it becomes increasingly apparent that the changes are not part of
normal aging.
Early symptoms can include subtle changes in
speech, mood, cognition, and behavior. For example, a person can become
apathetic or seem slow to comprehend new information. In addition, early
symptoms include:
- Slowing of movement
- Stiffness in the muscles of the neck and
limbs
- Unsteadiness and loss of balance, leading to
falls
- Vision problems, such as blurriness, dry eyes,
or difficulty focusing and following
Sometimes these symptoms lead to a
misdiagnosis of Parkinson’s disease. Other symptoms that can distinguish PSP
from Parkinson’s include:
- A staring face
- Furrowed forehead
- Reduced blink rate
- Slow, dream-like gestures and movements
- Strained, slow voice
- Tendency to drop uncontrolledly into a chair
instead of lowering oneself
The disease affects different people
differently. Function declines over the course of five to 10 years, but the
rate of change and the symptoms can vary. As the disease progresses, patients might
experience:
- Confusion
- Decreased skill in hand function
- Dementia
- Depression
- Heightened emotions (laughing or crying at
minor stimuli)
- Impaired speech and swallowing
- Postural instability leading to recurrent
falls, especially backward falls when changing direction
- Slower movements
In very advanced PSP, maintaining proper
nutrition becomes more difficult, and declining lung clearance is common in the
final stages of illness.
