Progressve Supranuclear Palsy

Question 1

Signs of progressive supranuclear palsy?

Answer 1

Restricted eye movements vertically but no paralysis of eye movements: if you move their head and ask them to keep their eyes on a fixed point, they can move their eyes up & down - its voluntary movements only affected. This might make it difficult to pt to walk down stairs and to read
Applause sign positive - if you get them to copy you exactly clapping 3 times they wont be able to do this
If you slightly unbalance the pt they will fall backwards. They will often have Hx of recurrent falls. This is axial rigidity
If you get a pt to stand up from a seated position they might have a sudden impulse to stand up - rocket sign
Rigidity
Freezing of gait
Hypokinesia - good speed of finger tapping OR they may have bradykinesia
Cognitive impairment
Urinary symptoms
Constipation
Sleep abnormalities can occur
Gait is typically stiff & broad based
Difficulty swallowing
Behavioural changes
Speech changes

Note tremor is rare