What are the symptoms of progressive supranuclear palsy?

Many people do not understand what kind of disease progressive supranuclear palsy is. Simply put, it is a neurodegenerative disease. So what are the specific symptoms of this disease?

1. Most patients develop the disease between the ages of 45 and 75 (average 50), with a course of 6 to 10 years. The onset is insidious, the course of the disease is slow and progressive, and there is a slight prevalence in males. Common initial symptoms include fatigue, drowsiness, and falling without cause (often falling backwards), and about 81% of patients have symmetrical symptoms. The early manifestations of movement disorders are unstable gait and balance disorders. In about 63% of cases, the first symptom is unstable gait, walking with large steps, straight and stiff knees, crossing of lower limbs when turning, and easy falling. This is caused by oculovestibular dysfunction, trunk stiffness and lack of movement. This gait is different from the short steps, jerky gait, and difficulty turning that are seen in patients with Parkinson's syndrome.

2. Ocular movement disorder is a characteristic manifestation of this disease, with paralysis of the eyes' upward and downward gaze. Generally, it starts with bilateral volitional downward gaze paralysis, with the patient complaining of difficulty walking on tiptoe or difficulty eating food on the table. The upward gaze function is gradually damaged and becomes complete vertical gaze paralysis, with the eyeballs fixed in the midline position. In the late stage, more than 2/3 of patients may have bilateral lateral gaze paralysis, 1/3 of patients have internuclear ophthalmoplegia, and some patients have inability to converge their eyes, pupil constriction, and light reflex and convergence reflex. The presence of ocular head reflex and Bell phenomenon indicates supranuclear lesions, while the disappearance of ocular head reflex in the late stage indicates nuclear lesions.

3. Common symptoms of pseudobulbar palsy such as slurred articulation, dysphagia, hyperreflexia of pharyngeal muscles, tongue stiffness and emotional instability may cause aspiration pneumonia. Symptoms of pyramidal tract damage such as hyperreflexia and Babinski sign may occur, as well as emotional disorders. In a few patients, wrinkles appear on the face due to rigidity, hypokinesia and high facial muscle tension, resulting in a look of surprise.

4. Cognitive and behavioral disorders appear relatively late, with about 52% of patients experiencing them in the first year of the disease, manifested by decreased cognitive function, decreased emotional activity, dementia, and poor spatial orientation memory test results. About 8% of patients experience this as the first symptom. Symptoms include slurred speech, difficulty in pronunciation, slow or fast speech, repetitive or echolalia, and ataxic speech. Frontal lobe symptoms include decreased speech fluency and imagery, difficulty in imitating or repeating speech, and personality changes.