Progressive supranuclear palsy (PSP) is a rare disorder that causes advancing deterioration of brain cells in the cortex, basal ganglia and brainstem. Collectively, these structures govern our ability to walk, balance and control basic eye movements. PSP affects roughly 20,000 Americans, and most typically strikes males over the age of 60. The exact cause of PSP is not known, and no specific treatments exist. Still, doctors have been successful in controlling at least some of PSP's most debilitating symptoms.
Problems of Diagnosis
PSP was once mistakenly believed to be a subset of Parkinson's disease, a more common ailment with its own lamentable effects. Even today, if you are experiencing the symptoms of PSP, there is a fair chance that at least some of your problems will be initially attributed to Parkinson's or dementia. Symptoms that may be misdiagnosed include problems with speech or swallowing, stiffness, awkward movement, forgetfulness, anxiety and rapid emotional changes. However, certain symptoms clearly differentiate PSP from these other ailments. They include an inability to control focus of the eyes and a loss of balance that leads to a backwards fall. Your vision problems may be particularly apparent when you look down. If you experience any of these symptoms, you should see your doctor at your earliest convenience.
Adapted Treatments
Drug treatments for PSP have been largely adapted from treatments for other disorders. If you have been diagnosed with PSP, your doctor will likely prescribe medications commonly used to treat Parkinson's. As a class, these drugs help increase levels of dopamine, a chemical responsible for accurate transfer of signals within the brain. They include amantadine, levodopa and dopamine agonists. Roughly 30 percent of PSP patients experience some gains in balance control and ease of movement while taking these drugs. Unfortunately, effectiveness of treatment diminishes substantially over a year or two.
For reasons that are not well understood, certain antidepressants are also effective in treating some effects of PSP. Examples include amitriptyline, fluoxetine (Prozac) and imipramine (Tofranil). Consult your doctor for a thorough examination of drug treatment plans that might work for you.
Additional Therapies
Additional therapies are sometimes used to alleviate other effects of PSP. These include physical therapy sessions to maintain control of movement; sessions with a speech therapist to counter difficulties with swallowing and use of prism lenses or bifocals to ease focusing problems. Injections of botulinum toxin (Botox) are sometimes used to paralyze small muscles around the eyes, thereby diminishing eyelid spasms.
Lifestyle Changes and Support
PSP patients will also benefit from certain modifications to home and lifestyle. If you are experiencing problems maintaining balance, try using a weighted cane or walker to help avoid falls. Also take the time to have railings installed in areas of your home where falls are most likely to occur. If you experience dry eyes from uncontrolled blinking, try using over-the-counter drops to help replace lost moisture.
You may also gain tremendous psychological benefit from joining a PSP support group, where you can share experiences with others in a similar position. Maintenance of strong family ties will also likely increase your ability to weather PSP's progressive effects.
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