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January 1982

Progressive Supranuclear Palsy and Falcotentorial Meningioma

Author Affiliations

Department of Neurology State University of New York Upstate Medical Center 750 E Adams St Syracuse, NY 13210

Arch Neurol. 1982;39(1):68. doi:10.1001/archneur.1982.00510130070027

To the Editor.—  Progressive supranuclear palsy (PSP) has been described in association with other apparently unrelated conditions.1-3 We describe a man with coincidental PSP and falcotentorial meningioma who posed problems in diagnosis.

Report of a Case.—  A 66-year-old man came to us in 1976 with a two-year history of impaired balance. Early unsteadiness of gait increased progressively, leading to frequent falls. He had trouble looking down, making it difficult to eat and to play cards. His gait was broad based, with a tendency to fall backward. Facies were immobile. Visual fields and acuities were normal, but vertical conjugate gaze, especially downward, was impaired on volition although intact with the doll's-head maneuver. Horizontal eye movements and pupillary reflexes were normal. He was severely dysarthric, with a brisk jaw jerk and poor tongue movements. Axial and limb rigidity were present with moderate bradykinesia, but no weakness or tremors were noted. Neck

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