Vascular progressive supranuclear palsy.
BACKGROUND
Progressive supranuclear palsy (PSP) is a neurologic syndrome of unknown cause. This idiopathic type of PSP is usually associated with characteristic clinical and pathological features.


OBJECTIVE
To assess evidence of cerebrovascular disease in a population of patients with clinically defined PSP, and to compare clinical and neuroimaging features in vascular versus idiopathic PSP.


METHODS
Using predetermined criteria, the records of 128 patients diagnosed with PSP were reviewed for evidence of vascular disease.


RESULTS
Thirty patients (23.3%) satisfied criteria for vascular PSP. The vascular group differed from the idiopathic group by asymmetric and predominantly lower body involvement (p < 0.05). Corticospinal signs, pseudobulbar signs, gait difficulties, dementia, and incontinence of bowels and bladder were also more common in the vascular group, but these differences did not reach statistical significance.


CONCLUSIONS
PSP is a syndrome which can be caused by cerebro-vascular disease. In addition to an increased frequency of stroke risk factors and neuroimaging evidence of vascular disease, vascular PSP can be differentiated from idiopathic PSP by a higher degree of asymmetry, lower body involvement, and evidence of corticospinal and pseudobulbar signs.
Department of Neurology, Baylor College of Medicine, Houston, Texas.
J
J
Winikates
J
J
Jankovic
D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013494:Supranuclear Palsy, Progressive / Q000209:etiology* / Q000473:pathology; D013577:Syndrome