What're the symptoms of progressive supranuclear palsy?
The earliest symptoms of progressive supranuclear palsy may be frequent falls or stiff, slow movements of the arms and legs. These symptoms may appear as much as five years before the characteristic vision problems. Walking becomes increasingly awkward, and some patients tend to lean and fall backward. Facial muscles may be weak, causing slurred speech and difficulty swallowing. Sleep may be disturbed and thought processes slowed. Although memory remains intact, the slowed speech and thought patterns and the rigid facial expression may be mistaken for senile dementia or Alzheimer's disease. Emotional responses may become exaggerated and inappropriate, and the patient may experience anxiety, depression, and agitation. Most patients with progressive supranuclear palsy display the characteristic findings of slowness of movement, stiffness, balance difficulty, and eye movement problems. The classic eye movement problem is an inability to voluntarily move the eyes downward, although this problem may take time to develop. Ultimately, all voluntary eye movements may be lost. Generally, the cognitive and behavioral symptoms are mild and less severe than in other types of dementia, such as Alzheimer disease and stroke-related dementia. These symptoms are more likely to occur in later stages of the disease.