Progressive Supranuclear Palsy
Signs and Symptoms

Loss of balance while walking is the most common first symptom of progressive supranuclear palsy (PSP). Patients may have unexplained falls or a stiffness and awkwardness when walking. Sometimes, the falls seem like attacks of dizziness, which lead to an incorrect diagnosis of an inner ear problem.

Other early symptoms include a loss of interest in hobbies or recreational activities, increased irritability and forgetfulness. Patients may suddenly laugh or cry, be apathetic or have occasional angry outbursts for no apparent reason.

As the disease progresses, many patients develop blurry vision and problems controlling eye movements. Patients have trouble shifting their gaze downward and can have trouble controlling their eyelids, leading to involuntary closing of the eyes, prolonged or infrequent blinking, or difficulty opening the eyes. Another visual problem is difficulty maintaining eye contact during a conversation, giving the impression that the patient is hostile or uninterested.

In addition, speech usually becomes slurred. Swallowing solid foods or liquids can be difficult. In rare cases, some patients will experience shaky hands.