Progressive supranuclear palsy is also known as "Steele-Richardson-Olszewski syndrome. It is a rare disease thatoccurs around the age of 55 years, can begin even at the age of75 years. Men are twice more affected than women.
Pathologically, the disease is characterized by loss of neurons inthe deck, midbrain, and cerebellar nuclei of the basal ganglia firstand by the presence of neurofibrilar balls in these regions.
From the biochemical point of view there is a decrease in the concentration of acid and dopamine homovanilic putamenului andthe caudate nucleus. It is often confused with Parkinson's disease.
The clinically characterized by supranuclear ophthalmoplegic pluspseudobulbara stiffness and paralysis, bradykinesia, posturalinstability phenomena and prefrontal.
Clinical onset paresis is by vertical movements of the eyeballs jointand slowly progressing to rigidity and dementia. It meets in the early stages of the disease often unable to conjugation eyeballswatching down oculocefalice reflexes are still preserved. The neckis fixed in hyperextension, progress is slow, with frequent drops.Speech is not affected. And seizures may occur during sleepapnea. Unfortunately, death occurs in 5-6 years after symptom onset. From the neuropathological point of view, Alzheimer-typechanges may occur in the cortex and even neuronal inclusions ofLewy type.
Most effective treatment is currently taking L-dopa, the answer isstill quite limited.
Dopaminergic preparations reduce rigidity and bradykinesia, Toimprove speech, gait disorders and anticholinergics can be usedas pseudobulbar trihexifenidil 6-15 mg / day or amitriptyline 50 to70mg administered at night before bed.
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