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Progressive Supranuclear Palsy
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Brain Nerves

Progressive Supranuclear Palsy

Progressive supranuclear palsy is a rare, progressive brain disorder that impairs movement, balance, eye control, and cognitive function.

What is progressive supranuclear palsy (PSP)?

Progressive supranuclear palsy (PSP) is a rare brain disease. It happens because of damage to nerve cells in the brain. PSP affects your movement, including control of your walking and balance. It also affects your thinking and eye movement.

PSP is progressive, which means that it gets worse over time.

What causes progressive supranuclear palsy (PSP)?

The cause of PSP is unknown. In rare cases, the cause is a mutation in a certain gene.

One sign of PSP is abnormal clumps of tau in nerve cells in the brain. Tau is a protein in your nervous system, including in nerve cells. Some other diseases also cause a buildup of tau in the brain, including Alzheimer's disease.

Who is at risk for progressive supranuclear palsy (PSP)?

PSP usually affects people over 60, but in some cases it can start earlier. It is more common in men.

What are the symptoms of progressive supranuclear palsy (PSP)?

Symptoms are very different in each person, but they may include:

  • A loss of balance while walking. This is often the first symptom.
  • Speech problems
  • Trouble swallowing
  • A blurring of vision and problems controlling eye movement
  • Changes in mood and behavior, including depression and apathy (a loss of interest and enthusiasm)
  • Mild dementia

How is progressive supranuclear palsy (PSP) diagnosed?

There is no specific test for PSP. It can be difficult to diagnose, because the symptoms are similar to other diseases such as Parkinson's disease and Alzheimer's disease.

To make a diagnosis, your health care provider will take your medical history and do physical and neurological exams. You may have an MRI or other imaging tests.

What are the treatments for progressive supranuclear palsy (PSP)?

There is currently no effective treatment for PSP. Medicines may reduce some symptoms. Some non-drug treatments, such as walking aids and special glasses, may also help. People with severe swallowing problems may need gastrostomy. This is a surgery to insert a feeding tube into the stomach.

PSP gets worse over time. Many people become severely disabled within three to five years after getting it. PSP isn't life-threatening on its own. It can still be dangerous because it increases your risk of pneumonia, choking from swallowing problems, and injuries from falling. But with good attention to medical and nutritional needs, many people with PSP can live 10 or more years after the first symptoms of the disease.

Frequently Asked Questions

Install grab bars in the bathroom, use a sturdy walker or cane, keep floors clear of cords and rugs, improve lighting, wear non‑slip shoes, and consider a physical therapist‑guided balance program. Arrange furniture to allow wide pathways and consider a bedside commode if nighttime bathroom trips are needed.
No drug reliably restores vertical eye movement, but eye‑patches or prisms can aid vision. For swallowing, speech‑language pathologists can teach safe swallowing techniques and recommend diet modifications (e.g., thickened liquids). Some clinicians use off‑label levodopa or amantadine to modestly improve gait, but they do not fix eye or swallowing issues.
Early PSP often shows frequent falls (especially backward) within the first year, difficulty looking down (vertical gaze palsy), stiff neck or neck extension, and speech that becomes slurred or hoarse quickly. Parkinson’s disease usually starts with a tremor and improves with levodopa, while PSP symptoms tend to be less responsive to Parkinson medications.
Begin discussions as soon as the diagnosis is confirmed. Contact a multidisciplinary PSP clinic or movement‑disorder specialist for care coordination. Look into home health aides, occupational therapy for home adaptations, and support groups (e.g., PSP Association). Discuss advance directives, durable power of attorney, and consider long‑term care insurance or Medicaid planning early, as disease progression can be rapid.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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