Progressive Supranuclear Palsy (PSP): A Simple, Plain-English Guide for Families & Caregivers

Progressive Supranuclear Palsy (PSP): A Simple, Plain-English Guide for Families & Caregivers

Progressive Supranuclear Palsy (PSP) is a rare neurological condition that affects movement, balance, vision, speech, and thinking. It can look very similar to Parkinson’s disease in the beginning, which is why many families experience confusion or delayed answers. PSP is not caused by anything a person did—it develops slowly over time as certain brain cells begin to degenerate.

This Brain Injury 101 guide breaks PSP down in a calm, simple, and easy-to-understand way.

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What Is PSP?

PSP is a progressive neurodegenerative disorder, meaning symptoms gradually worsen as brain cells in specific areas begin to die. These areas control balance, eye movement, and complex thinking skills. PSP is linked to abnormal buildup of tau protein—the same protein involved in several other neurodegenerative conditions.

Most people diagnosed with PSP are over age 60, but symptoms can begin earlier.

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Common Early Symptoms

1. Frequent, Unexplained Falls

One of the earliest clues is falling backward without warning. People may say their feet “don’t respond” or that they lose balance even on flat ground.

2. Vision and Eye Movement Problems

This is one of PSP’s biggest differences from Parkinson’s.
People often struggle to move their eyes up or down, blink normally, or shift their gaze quickly. This can cause:

• A fixed stare

• Trouble reading

• Blurred or double vision

• Difficulty going down stairs

3. Stiff or Slowed Movements

Movements may feel slow, stiff, or heavy. Unlike Parkinson’s—which often starts on one side—PSP is usually symmetrical from the beginning.

4. Speech and Swallowing Changes

Speech can become soft, slow, or slurred. Swallowing becomes more difficult over time, increasing the risk of choking or aspiration.

5. Emotional and Cognitive Changes

PSP can impact behavior and thought-processing.
Common changes include:

• Apathy

• Irritability

• Slowed thinking

• Mild memory problems

• Difficulty planning or organizing

These symptoms may look like depression or personality shifts.

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Why PSP Is Often Confused With Parkinson’s

PSP shares several features with Parkinson’s disease:

• Slow movement

• Muscle stiffness

• Balance trouble

But there are important differences:

Because early symptoms can overlap, PSP is commonly misdiagnosed for months or even years.

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How PSP Progresses

PSP tends to progress steadily over 5–10 years:

• Early years: balance issues, stiff movement, vision changes

• Middle years: speech and swallowing difficulties become more noticeable

• Later years: need for daily assistance, increased risk of pneumonia, infections, and falls

There is currently no cure, but treatments can help manage symptoms and improve quality of life.

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Why Early Recognition Matters

The earlier families understand what is happening, the more:

• Safety can be improved

• Fall risks can be reduced

• Swallowing assessments can be done

• Support systems can be put in place

• Caregivers can adjust to the emotional and physical changes

Knowing the diagnosis leads to better care—and more compassion for what is happening in the brain.

 

👉 Progressive Supranuclear Palsy: Symptoms, Misdiagnosis, Disease Course, and What Families Should Know
https://robbinsnestalliance.com/blogs/the-nesting-journal-1/progressive-supranuclear-palsy-psp-symptoms-misdiagnosis-disease-course-and-what-families-should-know

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Sources

NHS (Progressive Supranuclear Palsy)
NINDS – National Institute of Neurological Disorders and Stroke
PSP Association
Paris Brain Institute
Oxford Academic Research on PSP Progression