Fernández-Ferreira Ricardo, García-Santos Raúl Anwar, Rodríguez-Violante Mayela, López-Martínez Coral, Becerra-Laparra Ivonne Karina, Torres-Pérez María Eugenia
Internal Medicine Department, Médica Sur Clinic & Foundation, PC 14050, Mexico City, Mexico.
Neurology Department, National Institute of Neurology and Neurosurgery, PC 14269, Mexico City, Mexico.
Rev Esp Geriatr Gerontol. 2019 Sep-Oct;54(5):251-256. doi: 10.1016/j.regg.2019.04.002. Epub 2019 Jul 16.
Progressive supranuclear palsy (PSP) is a syndrome characterized by progressive parkinsonism with early falls due to postural instability, typically vertical gaze supranuclear ophthalmoplegia, pseudobulbar dysfunction, neck dystonia and upper trunk rigidity as well as mild cognitive dysfunction. Progressive supranuclear palsy must be differentiated from Parkinson's disease taking into account several so-called red flags.
We report a case series hallmarked by gait abnormalities, falls and bradykinesia in which Parkinson's disease was the initial diagnosis.
Due to a torpid clinical course, magnetic resonance imaging (MRI) was performed demonstrating midbrain atrophy, highly suggestive of progressive supranuclear palsy.
The neuroradiological exams (magnetic resonance imaging, single photon emission computer tomography, and positron emission tomography) can be useful for diagnosis of PSP. Treatment with levodopa should be considered, especially in patients with a more parkinsonian phenotype.
进行性核上性麻痹（PSP）是一种综合征，其特征为进行性帕金森综合征，因姿势不稳导致早期跌倒，典型表现为垂直凝视核上性眼肌麻痹、假性球麻痹功能障碍、颈部肌张力障碍和上躯干强直以及轻度认知功能障碍。考虑到一些所谓的警示信号，进行性核上性麻痹必须与帕金森病相鉴别。
我们报告了一组以步态异常、跌倒和运动迟缓为特征的病例系列，最初诊断为帕金森病。
由于临床病程进展缓慢，进行了磁共振成像（MRI）检查，显示中脑萎缩，高度提示进行性核上性麻痹。
神经放射学检查（磁共振成像、单光子发射计算机断层扫描和正电子发射断层扫描）对PSP的诊断可能有用。应考虑使用左旋多巴进行治疗，尤其是对于具有更多帕金森样表型的患者。
