STAGES OF PROGRESSIVE SUPRANUCLEAR PALSY( PSP)
Stages of Progressive Supranuclear Palsy( PSP)
PSP is an adult-onset neurodegenerative disease that impacts movement, thinking, speech and vision. PSP progresses over time and the distinctions between stages aren’ t always clear. There are some notable changes that happen throughout the disease, and those are often marked as four main“ stages”. Knowing what may lie ahead helps to plan and prepare as symptoms and care needs progress over time.
It’ s important to remember that everyone with PSP experiences the disease differently. Symptoms and their severity vary widely, and someone can be in each stage from anywhere between 1 to 5 years. The symptoms and the impact on daily life can also depend on the subtype of PSP that a person is living with. These differences make it difficult to compare one disease journey to another. For example, some middle or late-stage symptoms may start in the early stage, while others may not experience typical early onset symptoms until later. However, it can be helpful to use some of these markers to know roughly where someone is in the disease journey so that the best treatment and care can be decided.
Early Stage
The early stage of PSP is when people begin to experience symptoms. Some people in the early stage are bothered enough by their symptoms that they visit their primary care practitioner, a neurologist or a different healthcare professional. Many people in this stage are initially diagnosed with Parkinson’ s disease due to similar motor symptoms. Some people receive a clinical diagnosis of PSP while in this stage, but not all. Below are symptoms people may experience in the early stage: Motor or movement symptoms people may experience:
• Occasional falls that are often unexplained
• Slowed movements
• Mildly slowed, softer and / or slurred speech
• Occasionally a mild tremor Visual symptoms people may experience:
• Mild double vision Non-motor symptoms people may experience:
• Fatigue
• Mild changes to thinking that may impact ability to easily socialize
• Possible personality or mood changes Impact on daily living:
• Little to no assistance is needed from other people or devices to perform daily activities, but it can improve safety, convenience or comfort
Treatment, care or resources people can utilize:
• Outpatient rehabilitation therapies such as physical, occupational or speech therapy
• Regular exercise
• Possible benefit from oral medications, such as carbidopa-levodopa
• Evaluation to capture baseline swallowing function( often a modified barium study or sometimes a fiberoptic endoscopic evaluation of swallowing( FEES))
• Specialists as needed, such as neuro-ophthalmology or urology
• Driving evaluation