To the Editor.—
I found the case reported by Nuwer (Archives 1981; 38:784) to be very interesting. He described a 59-year-old woman with a four-year history of progressive extrapyramidal dysfunction in whom supranuclear ophthalmoparesis developed, suggesting the diagnosis of supranuclear palsy. Although it is true that the original description of this syndrome stressed the early constant and striking presence of a supranuclear ophthalmoplegia, we also have seen the rare patient who has progressive extrapyramidal dysfunction and in whom the characteristic supranuclear ophthalmoplegia has developed, thus suggesting the correct diagnosis.The original description of this syndrome1 did, in fact, stress that this was not parkinsonism, but through our reading of this article it seems that the reason that these patients were not considered to have a parkinsonian syndrome was the presence of supranuclear ophthalmoplegia. Most clinical investigators working in the field of movement disorders would agree that many patients with
Weiner WJ, Nausieda PA. Parkinsonian Features and Progressive Supranuclear Palsy. Arch Neurol. 1982;39(10):672–673. doi:10.1001/archneur.1982.00510220070024
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