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December 1981

Progressive Supranuclear Palsy Despite Normal Eye Movements

Author Affiliations

Department of Neurology UCLA School of Medicine 710 Westwood Plaza Los Angeles, CA 90024

Arch Neurol. 1981;38(12):784. doi:10.1001/archneur.1981.00510120084018

To the Editor.—  Eye movement disturbances are a cardinal abnormality in the syndrome of progressive supranuclear palsy (PSP) described by Steele and colleagues.1.2 Impairment of voluntary eye movements, especially vertically, often occurs early.3 The supranuclear, nonparalytic character of the disorder is demonstrated by preservation of full oculocephalic reflex movement. Multiple other oculomotor abnormalities have been described.4.5 However, this emphasis on ocular disorders can hinder the diagnosis in PSP patients with normal eye examination results.

Report of a Case.—  A 59-year-old woman noticed the gradual appearance of a gait disorder and slurred speech. During the next four years, this progressed so that she would topple over inexplicably in any direction, occasionally bruising herself. Clumsy fine movements eventually disabled her from her job as a seamstress. Other activities were intact.Evaluation of the gait disorder by a series of neurologists failed to result in a diagnosis. A family practitioner

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