CLINICAL-DIAGNOSIS AND DIAGNOSTIC-CRITERIA OF PROGRESSIVE SUPRANUCLEAR PALSY (STEELE-RICHARDSON-OLSZEWSKI SYNDROME)

Progressive supranuclear palsy (PSP) is characterized clinically by su pranuclear gaze palsy, neck dystonia, parkinsonism, pseudobulbar palsy , gait imbalance with frequent falls and frontal lobe-type dementia. I n the advanced typical case, when supranuclear gaze palsy and other ma in features are present diagnosis is relatively easy. Diagnostic probl ems, though, are frequent in the early stages due to the variable clin ical presentation and in those atypical cases in which gaze palsy does not develop or that present as a severe dementing disorder or as an i solated akinetic-rigid syndrome. In this review we summarize the clini cal features of PSP and emphasize those aspects helpful in the differe ntial diagnosis with Parkinsnon's disease and other motor and cognitiv e disorders that can pose difficult diagnostic problems. Clinical diag nostic criteria are also discussed and modifications of those currentl y in used are proposed.