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progressive supranuclear palsy

Nonpharmacological Methods for Reducing Falls Risk Among Individuals Living with Progressive Supranuclear Palsy

Nonpharmacological Methods for Reducing Falls Risk Among Individuals Living with Progressive Supranuclear Palsy

Teaser: 

Tichenoff, A.1,2 Holmes, J.D.1,3 Klapak, H.2 Lemmon, J.2 Picanco, M.2 Torrieri, A.2 and Johnson, A.M.1,2
1Health and Rehabilitation Sciences, The University of Western Ontario, London, ON, Canada. 2School of Health Studies, The University of Western Ontario, London, ON, Canada. 3School of Occupational Therapy, The University of Western Ontario, London, ON, Canada.

Abstract
Progressive Supranuclear Palsy (PSP) is a fatal neurodegenerative disorder that is characterized by gaze palsy, bradykinesia, postural instability, and mild dementia. PSP is one of the most common parkinsonian disorders, second only to Parkinson's disease. Of primary concern to individuals with PSP are issues related to reduced mobility, particularly with regards to their increased frequency of falling backwards. Although medical treatment (predominantly pharmaceutical) has been found to be effective for improving some symptoms including slowness and rigidity, most of these interventions are only partially effective in maintaining and improving balance and gait. Mobility issues in PSP are, therefore, addressed primarily through fall prevention programs delivered by physical and occupational therapists. In this review article, we will provide an overview of the current literature that explores nonpharmacological methods for reducing fall risk among individuals living with PSP.
Key words: progressive supranuclear palsy, falls prevention, gait, balance, gait training, balance training, adaptive equipment.

Diagnosis and Management of Progressive Supranuclear Palsy

Diagnosis and Management of Progressive Supranuclear Palsy

Teaser: 

Amitabh Gupta, MD, Clinical Fellow, Movement Disorders Centre, Toronto Western Hospital, University of Toronto, ON.
Susan Fox, MD, Assistant Professor, Movement Disorders Centre, Toronto Western Hospital, University of Toronto, ON.

Progressive supranuclear palsy (PSP) is a rare, fatal neurodegenerative disease with limited treatment options that is characterized by gait and postural instability and a classical vertical supranuclear gaze palsy. Initially often misdiagnosed as idiopathic Parkinson’s disease (IPD), proper patient care in PSP may be delayed until late into the disease course, after dopaminergic medication fails to improve symptoms. Here, we review the diagnostic criteria that help to separate PSP from IPD and rarer forms of parkinsonian diseases to help clinicians with earlier recognition. We discuss current treatment concepts as well as ongoing experimental approaches that are derived from an emerging pathological understanding.
Key words: progressive supranuclear palsy, clinical diagnosis, imaging, differential diagnosis, management.

Frontotemporal Dementia -- March 2005

Frontotemporal Dementia -- March 2005

Teaser: 


Andrew Kertesz, MD, FRCP(C), Director of Cognitive Neurology, St. Joseph’s Health Center, University of Western Ontario, London, ON.
David Munoz, MD, FRCP(C), Department of Pathology, St. Michael’s Hospital, University of Toronto, Toronto, ON.

Frontotemporal dementia (FTD or Pick’s disease) is a relatively common but underdiagnosed form of presenile dementia. Estimated prevalence is 20% of dementias and 50% of dementia in patients under age 65. Common presentations are disinhibition with indifference; progressive aphasia; semantic dementia; unexplained falls, vertical gaze palsy, and dysarthria; and dementia with motor neuron disease. Neuroimaging is essential to exclude a slow tumour. Tau mutations are found in some families. Atypical neuroleptics and antidepressants can effectively treat some of the characteristics of FTD.

Key words: frontotemporal dementia, Pick’s disease, primary progressive aphasia, corticobasal degeneration, progressive supranuclear palsy.