The diagnosis

As examination methods for diagnosis are possible:

Physical examination
Magnetic resonance imaging (MRT) -> Illustration of the altered shape of the brain stem
Nuclear medical procedures (PET) – Dopamine activity
Posturography
Examination of the nerve water (cerebrospinal fluid) to rule out other alternative diseases

Alternative diseases that must be excluded:

Morbus Parkinson
Morbus Alzheimer
Wilson’s disease is a rare copper storage disease that can also cause disorders in the brain stem, the so-called substantia nigra. You can find out more under our topic: Wilson’s disease

Similarity to Parkinson’s disease

Regions in the brain that are responsible for the eyes are in close proximity to regions for speaking and swallowing, which can also be affected in the further course of the disease, which can also make one think of Parkinson’s disease. Compared to patients with Parkinson’s disease, the speed of speech is slower. The voice pitch is also lower than in patients with Parkinson’s disease.

Gait insecurity also occurs increasingly during the course of the disease. The “rigor” typical of Parkinson’s disease – a waxy resistance that can be detected as a result of passive movement of the joints – also occurs in patients with progressive supranuclear gaze paresis. Shaking (tremor), which typically occurs in Parkinson’s disease, is rather rare in patients with progressive supranuclear palsy (PSP).

The Therapy

The central therapeutic approach is a drug-based one. However, drug therapy can alleviate the symptoms of progressive supranuclear palsy (PSP), but cannot stop the disease itself. The following medications are used: .

L-Dopa (converts the brain into the messenger substance dopamine) As a rule, the effect diminishes after 2-3 years.
Amantadine
Dopamine agonists
Rasagalin and selegiline reduce the breakdown of dopamine in the brain
Amitriptyline and Imipramine both so-called tricyclic antidepressants, they are used to treat depressive moods
Serotonin reuptake inhibitor (SSRI)
Botulinum toxin is used to treat eyelid cramps
Coenzyme Q10