Objective: We report an observation of a case received at the consultation in the Neurology Department of National Teaching Hospital Fann.

Background: Progressive supranuclear palsy (PSP) is a neurodegenerative disease (see the image below) whose characteristics include supranuclear, initially vertical, gaze dysfunction accompanied by extrapyramidal symptoms and cognitive dysfunction. The disease usually develops after the sixth decade of life. and the diagnosis is purely clinical.

Methods: Patient of 67 years , without specific medical history , which has since 6 months: falls, difficulty maintaining the sitting position , execution of daily activities ( eating, bathing … ) , urination, and alteration of mood behavior with loss of interest in pleasurable activities.

The patient was in fairly good condition, and has an extrapyramidal syndrome without tremors, lateral gaze palsy, and a frontal syndrome. His  MMSE’ score was 14/30.

The MRI shows a bi-frontal atrophy with shrinkage of the midbrain.

Results: The treatment with L-dopa was inefficient with no improvement. 

Conclusions: The diagnosis of progressive supra nuclear palsy is purely clinical. Key features typically develop over time. Physical therapy and rehabilitation medicine involvement may help maximize ambulation safety and facilitate instruction in the use of a walker, wheelchair, or other aids.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/progressive-supranuclear-palsy-about-one-case-at-the-neurology-department-dakar/