Table 2

Key differences in symptoms and signs in PSP and Parkinson’s disease

PSPParkinson’s disease
Symmetrical Yes No
Rigidity Axial Limb
AkinesiaSevere, global
Even in loose limbs
Mild to moderate
Tremor No Yes
Falls Early, spontaneous Late, with freezing
Eyes Vertical paresis Normal*
VoiceDysarthrophonia, distorted, poor volume controlHypophonia, quiet
CognitionMarked early executive changes
Loss of fluency
Subtle early executive changes or later dementia
LevodopaPoor responseVery good response
GaitHead up, sniffing the air
Leaning back
Head down, stooped, leaning forward
Looks like Parkinson’s? No Yes
  • Bold text highlights the simplest quick-six to have in mind.

  • * Subtle oculomotor abnormalities occur

  • PSP, progressive supranuclear palsy.