Progressive Supranuclear Palsy: The Parkinson’s Mimic

You may have heard of Parkinson’s Disease (PD) — a neurological disorder that affects nearly 10 million people worldwide. But did you know that sometimes what seems to be an open and shut case of PD might be something much more uncommon?

It could be Progressive Supranuclear Palsy (PSP).

Both PD and PSP have similar symptoms, and can cause serious, life-long problems. But there are subtle differences between the two.

Let’s understand what PSP is, and also take a closer look at the available options of PSP treatment in India — and how it compares to the treatment of PD.

What is Progressive Supranuclear Palsy?

PSP is an uncommon brain disease that significantly impacts your motor control. People with this condition face serious problems with walking, proprioception (coordination and balance), eye-movement, and swallowing.

The condition is caused by the degeneration of brain cells that control body movement. It is a progressive disease that invariably leads to life-long and life-threatening complications such as pneumonia and dysphagia (difficulty swallowing).

Early symptoms of PSP include:

• Sudden loss of balance while walking, often resulting in falls
• Muscle stiffness, particularly in the neck
• Exhaustion and extreme tiredness
• Changes in personality — irritability, apathy, mood swings
• Difficulty controlling eye muscles, particularly when looking up or down
• Blurred or double vision

These symptoms will gradually lead to the patient experiencing:

• Slurred or slowed speech
• Dysphagia
• Reduced blinking reflex — leading to dry and irritated eyes
• Involuntary closing of the eyes from anywhere from a few seconds to a few hours
• Disturbed sleep
• The slowness of thought or memory problems
• Neck or back pain, joint pain, and headaches

In its advanced stages, PSP causes slowed and slurred speech that hinders communication. Loss of control in the throat muscles also leads to severe swallowing issues and may require the insertion of a feeding tube to prevent choking and chest infections.

There have been many cases of PSP reporting loss of bladder and bowel control.

PSP also impacts the patient’s emotional and mental sensibilities, with many of them displaying cognitive challenges, concentration and memory troubles, though they usually do not lose complete awareness of themselves.

Difference between and PSP and PD

You may have realised that many of the symptoms of PSP are similar to the symptoms of PD, a more common neurological condition. After all, both PSP and Parkinson’s are characterized by parkinsonism — stiffness, slowness, and clumsiness in movement. In fact, PSP has often been misdiagnosed as PD due to how uncommon the disease is. But while the two are similar, there are still some differences that we need to be aware of.

Symptoms of PD

Vision difficulties

Usually presents as double vision, uncontrolled blinking, or excessive blinking

Tremors

Present in over 70% of cases

Balance

A tendency to bend forwards

Swallowing issues

Mild to moderate

Sense of smell

Degrades over time

Symptoms of PSP Progressive Supranuclear Palsy

Vision difficulties

Usually presents as difficulty in upward/downward eye movement, later stages may develop double vision and involuntary closing of eyes

Tremors

Present in under 10% of cases

Balance

A tendency to fall backwards

Swallowing issues

Moderate to severe

Sense of smell

Tends to remain the same

Treatment of PSP

There are some similarities between the treatment of PD and treatment of PSP. However, since some symptoms are present more severely in PSP, there are some specific differences in its treatment.

Most patients will be working with a multidisciplinary team of neurologists, social workers, ophthalmologists, dieticians, and therapists (speech, occupational, and physiotherapists) to create a treatment plan. Treatment for PSP involves mitigating the symptoms as much as possible. If you are a patient of PSP, your treatment plan might include:

• Medication — Parkinson’s medication may be prescribed to help control your muscle movement. However the effects of these are limited and temporary, usually lasting only two to three years. Antidepressants might also be prescribed to combat the depression and sleep problems that often accompany PSP
• Physiotherapy — You will be given exercises that help you strengthen your muscles and help you regain a little control over your movements. A physiotherapist can also advise you on specialized equipment such as walking frames to improve balance or special shoes to help prevent slippage
• Speech and Language Therapy — A therapist will work with you to help manage and overcome speech problems like slurring, as well as dysphagia
• Occupational Therapy — You will learn how to stay safe and prevent falls and other accidents in your day to day life
• Dietary Changes — You may be referred to a dietician who can help you maintain a healthy diet while finding foods and liquids that are easier to swallow
• Eye Care — Loss of control over the eyelids may be treated with small amounts of Botox injected around the eyelid. Botox can help block the muscle spasms in the area. An ophthalmologist may also suggest bifocals or prism lenses to help with downward eye movement
• Stem Cell Therapy — Autologous stem cell therapy for PSP can help treat the disorder at its root cause. Stem cells, which can take on the function of any cell and can accelerate healing at the cellular level, are extracted from the patient’s bone marrow, developed, and then injected intravenously. They can help rebuild degenerated brain cells and improve the overall functioning of the patient

Due to the self-renewal, anti-inflammatory, immunomodulatory, signaling, and differentiating characteristics of stem cells, stem cell therapy can go a long way in slowing the progress of the PSP and even empower patients to better manage their symptoms.

Plexus Neuro and Stem Cell Research Centre is India’s first ISO-certified stem cell research centre. Founded by Dr Na’eem Sadiq, Plexus offers a holistic regenerative rehabilitation program for progressive supranuclear palsy. We use autologous stem cells taken from the patient’s own body. The procedure is conducted by Dr. Sadiq, India’s no. 1 stem cell specialist, and his team of highly-skilled and experienced stem cell specialists.

Living with Progressive Supranuclear Palsy is difficult and often frightening, but remember that you’re not alone in this experience. Creating a support system both in your personal life and treatment journey can go a long way in helping you cope with the condition. Confide in your friends and family, and look into rehabilitation centers that offer treatment of Parkinson’s Disease and PSP — start building your network of care today.

Reach out to Dr Sadiq and his team of specialists at Plexus Neuro Centre today.

Call +91 89048 42087 | 080-2546 0886

080-2547 0886 | 080-2549 0886

A highly regarded neurologist and stem cell specialist, Dr Na’eem Sadiq studied neurology and clinical neurophysiology in London before working with some of England’s and the Middle East’s most prestigious medical institutions. He completed his MBBS