The early symptoms of progressive supranuclear palsy (PSP) are often attributed to the aging process. In many cases, after a few months, it becomes increasingly apparent that the changes are not part of normal aging.
Early symptoms can include subtle changes in speech, mood, cognition, and behavior. For example, a person can become apathetic or seem slow to comprehend new information. In addition, early symptoms include:
- Slowing of movement
- Stiffness in the muscles of the neck and limbs
- Unsteadiness and loss of balance, leading to falls
- Vision problems, such as blurriness, dry eyes, or difficulty focusing and following
Sometimes these symptoms lead to a misdiagnosis of Parkinson’s disease. Other symptoms that can distinguish PSP from Parkinson’s include:
- A staring face
- Furrowed forehead
- Reduced blink rate
- Slow, dream-like gestures and movements
- Strained, slow voice
- Tendency to drop uncontrolledly into a chair instead of lowering oneself
The disease affects different people differently. Function declines over the course of five to 10 years, but the rate of change and the symptoms can vary. As the disease progresses, patients might experience:
- Confusion
- Decreased skill in hand function
- Dementia
- Depression
- Heightened emotions (laughing or crying at minor stimuli)
- Impaired speech and swallowing
- Postural instability leading to recurrent falls, especially backward falls when changing direction
- Slower movements
In very advanced PSP, maintaining proper nutrition becomes more difficult, and declining lung clearance is common in the final stages of illness.
