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Tests and diagnosis
By Mayo Clinic staffYour doctor diagnoses progressive supranuclear palsy by identifying the disorder's key signs — problems with balance and walking and difficulty moving your eyes, particularly downward — and ruling out other similar disorders.
Progressive supranuclear palsy can be difficult to diagnose because some signs and symptoms, such as stiffness, movement difficulties and changes in mood or personality, are similar to those of Parkinson's disease and dementia. In fact, because of its similarity to Parkinson's disease, it's considered a "parkinsonism-plus syndrome." Indications that you have progressive supranuclear palsy rather than Parkinson's disease include a lack of shaking (tremors) and a poor response to Parkinson's medications, such as levodopa.
Magnetic resonance imaging (MRI) may be helpful, as shrinkage of specific regions of the brain may indicate progressive supranuclear palsy, though more than just an MRI is needed to confirm a diagnosis.
Though a diagnosis can be made through this evaluation process, currently the only definitive way to determine whether a person has progressive supranuclear palsy is through a brain autopsy. This is important since other diseases can sometimes mimic the symptoms of progressive palsy. Studies are ongoing to develop medical tests that can help diagnose progressive supranuclear palsy.
- Progressive supranuclear palsy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/psp/detail_psp.htm. Accessed Dec. 14, 2010.
- Dickson DW, et al. Neuropathology of variants of progressive supranuclear palsy. Current Opinion in Neurology. 2010; 23:394.
- Ropper AH, et al. Degenerative diseases of the nervous system. In: Ropper AH, et al. Adams and Victor's Principles of Neurology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=3639296&searchStr=progressive+supranuclear+palsy. Accessed Dec. 14, 2010.
- Hyun JH, et al. Behavioral changes as the earliest clinical manifestation of progressive supranuclear palsy. Journal of Clinical Neurology. 2010;6:148.
- Golbe LI. Progressive supranuclear palsy: Some answers. CurePSP. http://www.psp.org/about. Accessed Dec. 14, 2010.
- Stamelou M, et al. Short-term effects of coenzyme Q10 in progressive supranuclear palsy: A randomized, placebo-controlled trial. Movement Disorders. 2008;23:942.
- Josephs KA (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 29, 2010.
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