II. Course

  1. Rapidly progressive or early Dementia
  2. Rapidly progressive course

III. Signs: Prominent features

  1. Upper Motor Neuron signs
    1. Axial rigidity is greater than extremity rigidity
  2. Cerebellar signs (dysmetria, Ataxia) with impaired gait
  3. Impaired speech
  4. Urinary Incontinence
  5. Early symptomatic Postural Hypotension
  6. Distinguishing features
    1. Resting Tremor absent
    2. Refractory to Carbidopa/Levodopa

IV. Signs: Progressive Supranuclear palsy (Supranuclear gaze palsy)

  1. Olfaction is normal
  2. Vertical gaze paralysis and postural instability
    1. Difficulty reading
    2. Loss of Down gaze

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