VASCULAR PROGRESSIVE SUPRANUCLEAR PALSY

Background: Progressive supranuclear palsy (PSP) is a neurologic syndr ome of unknown cause. This idiopathic type of PSP is usually associate d with characteristic clinical and pathological features. Objective: T o assess evidence of cerebrovascular disease in a population of patien ts with clinically defined PSP, and to compare clinical and neuroimagi ng features in vascular versus idiopathic PSP. Design and methods: Usi ng predetermined criteria, the records of 128 patients diagnosed with PSP were reviewed for evidence of vascular disease. Results: Thirty pa tients (23.3%) satisfied criteria for vascular PSP. The vascular group differed from the idiopathic group by asymmetric and predominantly lo wer body involvement (p < 0.05). Corticospinal signs, pseudobulbar sig ns, gait difficulties, dementia, and incontinence of bowels and bladde r were also more common in the vascular group, but these differences d id not reach statistical significance. Conclusion: PSP is a syndrome w hich can be caused by cerebro-vascular disease. In addition to an incr eased frequency of stroke risk factors and neuroimaging evidence of va scular disease, vascular PSP can be differentiated from idiopathic PSP by a higher degree of asymmetry, lower body involvement, and evidence of corticospinal and pseudobulbar signs.