Progressive supranuclear palsy

Progressive supranuclear palsy (PSP) is a rare and progressive condition where increasing numbers of brain cells become damaged over time. This is known as neurodegeneration.

The causes of PSP are unknown, but current research suggests that it's caused by a combination of environmental and genetic factors.

Most cases of PSP first develop in people who are 60-65 years of age, although the condition has been diagnosed in people as young as 40.

PSP symptoms

As PSP is a progressive condition, the initial symptoms will become more severe over time, and new symptoms can develop.

The rate at which the symptoms progress can vary widely from person to person but early symptoms can include:

progressive problems with balance and mobility
changes in behaviour, such as irritability or apathy (lack of interest)
an inability to control eye and eyelid movement, including focusing on specific objects or looking down at something (dystonia)

Later symptoms can include:

increasing difficulty speaking and swallowing (dysphagia)
becoming increasingly forgetful or having difficulty concentrating

Diagnosing PSP

There's no single test for diagnosing PSP. Instead, the diagnosis is based on the type and pattern of your symptoms. Other conditions that can cause similar symptoms, such as Parkinson's disease, will also be ruled out.

The diagnosis must be made or confirmed by a consultant with expertise in PSP (this will usually be a neurologist).

If you have symptoms that suggest there's something wrong with your brain, it's likely you'll be referred for a brain imaging scan.

Treating PSP

There's currently no cure for PSP but research into the condition is continuing.

Treatment focuses on relieving the symptoms while trying to ensure that someone with PSP has the best possible quality of life.

As someone with PSP can be affected in many different ways, treatment and care is provided by a team of health and social care professionals working together. Specific symptoms of PSP might be treated with:

medication - to improve balance, stiffness and other symptoms
botulinum injections or special glasses - to help with eye problems
feeding tubes - to help manage dysphagia and avoid malnutrition or dehydration

Complications of PSP

PSP isn't life-threatening itself, but it can lead to serious complications.

Difficulty swallowing (dysphagia) is one of the common complications of PSP and can cause choking or inhaling food or liquid into the airways (aspiration). Aspiration can develop into pneumonia.

Mobility problems can also make someone with PSP vulnerable to falls, which can lead to head injuries and fractures in severe cases.

Good care and assistance can help people with PSP to be more independent and enjoy a better quality of life.

Read more about the complications of PSP.