Here’s an abstract about a very rare variant of progressive supranuclear palsy (PSP) – pallido-nigro-luysial atrophy (PNLA). The article is based on brain bank research from Mayo Jacksonville and Mayo Rochester. Researchers found:
“The clinical course of PSP-PNLA, however, was different, with earlier gait abnormalities and difficulty with handwriting, but later falls, rigidity and dysphagia than PSP.”
According to the full article, dizziness can also be a symptom of PSP-PNLA.
The abstract is copied below.
Robin
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Brain. 2007 Dec 24 [Epub ahead of print]
Clinical and neuropathologic features of progressive supranuclear palsy with severe pallido-nigro-luysial degeneration and axonal dystrophy.
Ahmed Z, Josephs KA, Gonzalez J, Delledonne A, Dickson DW.
Department of Neuroscience, Mayo Clinic College of Medicine, Jacksonville, FL and Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Pallido-nigro-luysial atrophy (PNLA) is a rare disorder that in many cases has histopathological features similar to progressive supranuclear palsy (PSP). In a pathological series of over 400 cases of PSP, eight cases were noted to have features similar to those described in PNLA, including severe atrophy and neuronal loss in the globus pallidus, substantia nigra and subthalamic nucleus, in addition to many axonal spheroids in the globus pallidus and substantia nigra. These eight cases of PSP-PNLA were compared to 11 typical PSP cases with quantitative neuropathologic indices and assessment of demographics, clinical features and the timing of clinical features. PSP-PNLA cases were younger, had longer disease duration and more often were not initially diagnosed with PSP; in the end, they did not differ from PSP with respect to any major clinical feature. The clinical course of PSP-PNLA, however, was different, with earlier gait abnormalities and difficulty with handwriting, but later falls, rigidity and dysphagia than PSP. Pathologically, the same types of lesions were detected in both PSP and PSP-PNLA, but there were differences in the distribution and density of tau-pathology, with less tau-pathology in motor cortex, striatum, pontine nuclei and cerebellum in PSP-PNLA. These clinical and pathological findings suggest that PSP-PNLA should be considered a variant of PSP.
PubMed ID#: 18158316 (see pubmed.gov for the abstract only – available at no charge)