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The first clinicopathologic description of progressive supranuclear palsy ( PSP ) were published in 1963 and 1964.(1 )
The most common symptoms at disease onset were postural imbalance and falls ( 63 % ) , dysarthria ( 35 % ) ; bradykinesia ( 13 % ) .(1 )
How To Diagnose Progressive Supranuclear Palsy?
reform-minded supranuclear palsy is a degenerative condition for which the diagnosis making is clinical . It is because there is no specific trial run present that can sustain as well as specify the diagnosis of PSP at the same prison term . How to make the diagnosis on clinical features , the stylemark symptom of PSP such as supranuclear ophthalmoplegia , downward regard palsy of the eye should be present along with the supporting history such as presence of frequent falls , unnatural and wide gait , unfitness to see the path distinctly , etc . Other clinical feature such as cervix dystonia , pseudobulbar palsy may also be present which can facilitate in further strengthening the diagnosis.(2 )
Once the diagnosing is made by the physician based on clinical feature , it can be supported and nail down with the help of radiological , biochemical , and histologic testing . In the radiological interrogatory , MRIand SPECT can be performed which may show mind atrophy , periaqueductal grey matter changes , etc .
Biochemical examination of the cerebrospinal fluid could also help detect the protein levels peculiarly tau proteins which are confirmatory once the clinical diagnosis is made . The most specific and raw mental testing for the supporting diagnosis of reformist supranuclear palsy is a histological examination of the brain tissue . It is used for the detection of neurofibrillary maze , cerebral plaques in the brain tissue paper which gets accumulated due to unnatural tau protein and increases with age .
What Is The Best Medicine For Progressive Supranuclear Palsy?
To start the patient on any medicine , it is very crucial to exclude the differential diagnosis of this condition especially such as parkinsonism which is a fairly treatable disease . Although there has been widespread research upon this condition but a complete and permanent cure has not been find yet . Many of the cases reply to various dopaminergic and anticholinergic agents but do so for a short duration only . There have been no drug developed which can stop the advance of this condition and this condition is fairly an untreatable one .
Few groups of drug can be used such as dopamine agonists like bromocriptine , cabergoline , pramipexole , ropinirole , etc . , anticholinergic agents like trihexyphenidyl , benztropine , etc . , tricyclic antidepressants Elavil , nortriptyline , methysergide , etc.(3 )
In a few of the cases , where the pharmacologic therapy has faltered badly and there has been no symptomatic relief to the progressive supranuclear palsy patient with symptom seriously damaging the timbre of life , there has been advocation for the usage of electroconvulsive therapy . Although only indirect electroconvulsive therapy which is give under the effect of anesthesia is allowed.(4 )
Conclusion
Like most of the other degenerative conditions especially affect mentality and spinal cord , progressive supranuclear palsy is also progressive with limited mode of diagnosing and handling . Specific diagnosis and complete treatment are not possible in any of the case of this condition . Diagnosis fashioning is most of the clip , based on clinical examination and history . It can be adequately supported by radiological , biochemical , and histologic evidence but it can not be sustain on such test reports because a variety of other diseases also consists of a similar intro on these test .
After the recent advances in the field of pharmacological medicine , these degenerative condition have become a new predilection for the neurologists . scientist have been seek to completely stop the progression of this condition but have not find achiever yet . drug like Dopastat agonists can render relief on a unretentive term foundation .
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