eMedicine Specialties > Neurology > Movement and Neurodegenerative Diseases

Progressive Supranuclear Palsy: Follow-up

Author: Eric R Eggenberger, DO, MS, FAAN, Professor, Vice-Chairman, Department of Neurology and Ophthalmology, Colleges of Osteopathic Medicine and Human Medicine, Michigan State University; Director of Michigan State University Ocular Motility Laboratory; Director of National Multiple Sclerosis Society Clinic, Michigan State University
Coauthor(s): Zeba F Vanek, MD, MBBS, DCN, Associate Professor of Neurology, David Geffen School of Medicine at UCLA; Director, UCLA Spasticity Clinic; David Clark, DO, Resident Physician, Department of Neurology and Ophthalmology, Michigan State University College of Human Medicine
Contributor Information and Disclosures

Updated: Jan 5, 2010

Follow-up

Further Outpatient Care

  • To help the patient and family adjust to the changing needs incurred by PSP, provide close follow-up care. Be vigilant for adverse effects related to any medication trials. Often, family-directed education is the most valuable component of clinical visits.
  • Physical therapy and rehabilitation medicine involvement may help maximize ambulation safety and facilitate instruction in the use of a walker, wheelchair, or other aids.
  • Preliminary evidence suggests that the combination of balance training complemented with eye movement and visual awareness exercises can be beneficial for enhancing suppression of fixation and gaze shift in patients with PSP.48
  • Patients and families often benefit from contact with a PSP support group (see Patient Education).

Complications

The primary complications of PSP relate to impaired balance, decreased cognition, and immobility in late disease.

  • Complications related to falls include orthopedic injury and other posttraumatic problems.
  • Immobility in late disease leads to infectious complications such as pneumonia, urinary tract infection, and sepsis.

Prognosis

The disease runs a progressive and fatal course over 6-10 years in most patients (see Mortality/Morbidity).

Patient Education

Miscellaneous

Medicolegal Pitfalls

Misdiagnosis is always a potential medicolegal pitfall, especially in diseases without objective diagnostic tests. Consider treatable disorders such as idiopathic Parkinson disease. Offering the patient and family a second opinion in the setting of an untreatable fatal illness is always worthy of consideration.

 


More on Progressive Supranuclear Palsy

Overview: Progressive Supranuclear Palsy
Differential Diagnoses & Workup: Progressive Supranuclear Palsy
Treatment & Medication: Progressive Supranuclear Palsy
Follow-up: Progressive Supranuclear Palsy
References
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Further Reading

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Keywords

Steele-Richardson-Olszewski syndrome, PSP, parkinsonism, neurodegenerative disease, imbalance, immobility, dementia, visual symptoms, dysphagia, dysarthria, vertical gaze palsy

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Contributor Information and Disclosures

Author

Eric R Eggenberger, DO, MS, FAAN, Professor, Vice-Chairman, Department of Neurology and Ophthalmology, Colleges of Osteopathic Medicine and Human Medicine, Michigan State University; Director of Michigan State University Ocular Motility Laboratory; Director of National Multiple Sclerosis Society Clinic, Michigan State University
Eric R Eggenberger, DO, MS, FAAN is a member of the following medical societies: American Academy of Neurology, American Academy of Ophthalmology, American Osteopathic Association, and North American Neuro-Ophthalmology Society
Disclosure: Nothing to disclose.

Coauthor(s)

Zeba F Vanek, MD, MBBS, DCN, Associate Professor of Neurology, David Geffen School of Medicine at UCLA; Director, UCLA Spasticity Clinic
Zeba F Vanek, MD, MBBS, DCN is a member of the following medical societies: Movement Disorders Society
Disclosure: Nothing to disclose.

David Clark, DO, Resident Physician, Department of Neurology and Ophthalmology, Michigan State University College of Human Medicine
David Clark, DO is a member of the following medical societies: American Academy of Neurology and American Osteopathic Association
Disclosure: Nothing to disclose.

Medical Editor

Joseph Quinn, MD, Assistant Professor, Department of Neurology, Portland VA Medical Center, Oregon Health Sciences University
Joseph Quinn, MD is a member of the following medical societies: American Academy of Neurology, Society for Neuroscience, and Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Nestor Galvez-Jimenez, MD, MSc, MHA, Chairman, Department of Neurology, Program Director, Movement Disorders, Department of Neurology, Division of Medicine, Cleveland Clinic Florida
Nestor Galvez-Jimenez, MD, MSc, MHA is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

 
 
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