Progressive supranuclear palsy (PSP)

What is progressive supranuclear palsy (PSP)?

Progressive supranuclear palsy (PSP) is a condition that causes both dementia and problems with movement. It is a progressive condition that mainly affects people aged over 60.

The word ‘supranuclear’ refers to the parts of the brain just above the nerve cells that control eye movement. When a person has PSP these areas become damaged. ‘Palsy’ means a person is unable to move a part of their body – in this case their eye. For a person with PSP, this means:

• they may find it difficult to move their eyes in the direction they want to look – particularly up or down
• their eyes may not co-ordinate with each other, which causes blurred or double vision
• their eyelids may not open normally and may become stuck shut.

Symptoms of progressive supranuclear palsy (PSP)

About 1 in 10 people who have PSP have symptoms related to thinking and perception when they are diagnosed. However, about 7 in 10 people who have PSP are likely to develop dementia at some point.

Although memory is not often badly affected by the condition, PSP can affect other parts of a person’s thinking. This includes having problems with:

• concentration
• decision-making
• problem-solving
• organising
• planning.

People who have PSP can also have difficulties with their ability to work out how the things they see are arranged in space (visuospatial skills). This can make it difficult for them to judge how far away objects are, which may mean they fall or bump into things.

People who have PSP can also have problems with language. They may:

• find it difficult to read words and letters
• stutter or find it difficult to speak fluently
• use the wrong word – for example they may say ‘I taken the dog for a walk’ rather than ‘I took the dog for a walk’.

Over time they may also develop behavioural symptoms, such as becoming apathetic, stubborn, or impulsive.

PSP can cause symptoms related to movement, which may include:

• being stiff or slow
• having a jerky tremor (shaking)
• problems with balance
• problems with coordination (usually on one side of the body).

Treatments for progressive supranuclear palsy (PSP)

There is currently no cure for PSP. However, there are drugs and other therapies that can help to manage some of the symptoms.

The drugs that are used to treat the condition depend on the particular type of PSP the person has. In some types, people with PSP may be offered a drug known as levodopa. This boosts levels of dopamine in the brain and can help with slowness, stiffness and balance. If a person with PSP is struggling to open their eyelids this can sometimes be improved with injections of botulinum toxin (commonly known as ‘botox’).