Article About Prognosis For Progressive Supranuclear Palsy
Progressive supranuclear palsy is a rare disease that gradually destroys nerve cells in the parts of the brain that control eye movements, breathing, and muscle coordination. The loss of nerve cells causes palsy, or paralysis, that slowly worsens as the illness advances. The palsy has effects on capability to move the eyes, relax the muscles, and control balance.
Progressive supranuclear palsy is an illness of middle age. Symptoms customarily begin in the 60s, barely before age 45 or after age 75. Men develop PSP more frequently than ladies do. It has effects on three to four people per million each year.
Prognosis for progressive supranuclear palsy: has effects on the brainstem, the basal ganglia, and the cerebellum. The brainstem is found at the head of the spinal cord. It controls the most simple functions required for survival-the involuntary ( unwilled ) movements such as breathing, blood pressure, and heart rate. The brainstem has three parts : the medulla oblongata, the pons, and the midbrain. The parts influenced by PSP are the pons, which controls facial nerves and the muscles that turn the eye outward, and the midbrain, the visible center. The basal ganglia are islands of nerve cells found deep in the brain. They are involved in the initiation of voluntary ( willed ) movement and control of emotion. Damage to the basal ganglia causes muscle rigidity ( spasticity ) and tremors. The cerebellum is found at the base of the skull. It controls balance and muscle coordination.
Vision is controlled by groups of cells called nuclei in the brainstem. In PSP, the nuclei continue to function, but the mechanisms that control the nuclei are destroyed. The term supranuclear means that the damage is done above ( supra ) the nuclei. Patients with PSP have problems with voluntary ( willed ) eye movement. Initially, the difficulty only happens in making an attempt to look down. As the illness moves on, capability to move the eyes right and left is also affected. However reflex or unwilled eye movements remain standard. Thus, when the patient’s head is leaned upwards, the eyes move to look down. These reflex movements remain normal till late in the course of the disease. The higher eyelids may be pulled back, the eyebrows raised, and the brow wrinkled, causing a typical wide-eyed stare. Rate of blinking may decline from the normal 20-30 per minute to 3 to 5 per minute. It becomes difficult to walk downstairs, to maintain eye contact during conversation, or to move the eyes up and down to read.
The earliest symptoms of PSP could be frequent falls or stiff, slow movements of the legs and arms. These symptoms may appear as much as 5 years before the characteristic vision Problems. Walking becomes increasingly awkward, and some patients tend to lean and fall backward. Facial muscles may be feeble, causing slurred speech and difficulty swallowing. Sleep may be troubled and thought processes slowed. Although memory remains intact, the slowed speech and thought patterns and the rigid countenance could be mistaken for senile dementia or Alzheimer’s illness. Emotional responses may become exaggerated and inappropriate, and the patient may experience anxiety, depression, and agitation.
The cause of PSP is not known. The majority who develop PSP come from families with no history of the illness, so it does not appear to be inherited, except in certain rare instances. People who have PSP appear to lack the neurotransmitters dopamine and homovanillic acid in the fundamental ganglia. Neurotransmitters are chemicals that help carry electrical impulses along the nervous system. Broadcasting structures in brain cells called neurofibrils become disorganized ( neurofibrillary tangles ). Neurofibrillary tangles are also found in Alzheimer’s illness, but the pattern is rather different. Check out also cerebral palsy info.
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