Table 1

Symptoms and signs of PSP

Cognitive change (apathy, impulsivity)Akinetic rigidity—neck and axial rigidity >limbs ‘sniffing morning breeze sign’
Impaired balanceSlow saccades and ‘round the houses’ vertical saccades
Early falls (with increased fracture risk)Vertical supranuclear gaze palsy
Blurry or double visionFrontalis overactivity, reduced blink, staring expression
Sleep difficultiesTendency to lose balance spontaneously or on the ‘pull test’
Dysphagia (especially liquids)Uncontrolled decent into a chair
Drooling, sialorrhoeaDystonia, cervical, axial >limbs
Urinary urgency or incontinenceApraxia (CBS overlap)
ConstipationEmotional lability (pseudobulbar affect)
Depression or anxietyReduced verbal fluency
Hyperphagia and change in food preferencesDysarthrophonia
Weight loss (with possible malnutrition)
  • CBS, corticobasal syndrome; PSP, progressive supranuclear palsy.