Clinical case of a patient with progressive supranuclear palsy – from symptom to diagnosis

Abstract

Progressive supranuclear palsy (PSP) is a neurodegenerative disease classified among the atypical forms of parkinsonism. PSP is characterized by great variability in the involvement of different areas of the central nervous system (CNS). The clinical picture is associated with impaired gait and balance, generalized bradykinesia, visual impairment, dysarthria, dysphagia, pelvic incontinence, dementia and others. We present a clinical case of a 50-year-old woman who, at the end of 2021, was admitted to the Rheumatology department, UMBAL "St. Ivan Rilski" - Sofia, due to weakness in the hands, dropping objects, pain in small joints of the hands, disorder in coordination, difficulty walking and frequent stumbling, slurred speech, tremors involving both hands (more pronounced on the right), memory impairment, pelvic incontinence and hair loss. The clinical case is very indicative of the long journey that a patient with progressive supranuclear palsy takes before being correctly diagnosed.