| Objective:To summarize and discuss the characteristics of progressive supranuclear palsy(PSP) and to compare the similarities and differences between the Richardson’s syndrome and PSP-parkinsonism.And to improve our knowledge and diognosis of PSP.Methods:We retrospectively analyzed the clinical data of 18 inpatients diagnosed as progressive supranuclear palsy from September 2015 to February 2016 in the Department of Neurology, Qilu Hospital, Shandong University.The PSP criteria proposed by NINDS-SPSP was used. It is illustrated in detail about the medical history, physical examination, rating scale and cognative function(MMSE and MoCA). And the similarities and differences between the Richardson’s syndrome and PSP-parkinsonism was compared. All data is accord with normal distribution. Comparison between groups was done with independent sample T-test and chi-square test. P<0.05 denotes the difference possessing statistical significance. The data was analyzed by the software of SPSS 19.Results:1.18 cases are composed of 12 RS patients and 6 P type patients,the ratio is 2:1. These cases are consists of 10 (55.6%) men and 8 (44.5%) women,the ratio is 1.25:1.2.All the 18 cases are adults,50-85 years old.The average age is 64.11±9.33. And the average age of onset is 64.11±9.33.There is no significant differences between two types.3.The most common initial symptom is parkinsonian symptoms and number about 55.6% of all patients. And there are also other symptoms such as (33.3%),cognitive impairment(22.2%) and pseudobulbar palsy(16.7%).50% of RS patients begin postural instability,and most P type patients’ initial symptoms are parkinsonian symptoms.4.The most common symptoms during the disease course are postural instability,axial distonia,dysarthrosis,supranuclear palsy and personality changes.77.8% of the patients suffer from sleeping disorders and dysphagia.5.The average score of MMSE is 20.79±4.775 and the average score of P type patients are higher than the RS patients. (p<0.05) The average score of MoCA is 18.23±7.758. There is no significant differences between two types.Further analysis found that there are differences between the two types in the aspect of comprehension, visual space capability and orientation.6.The average score of PSPRS is 35.22±15.063 and it grown by an annual average of 12.23 points. Further analysis found that there are differences between the two types in the aspect of withdrawal,urinary incontinence,mentation and eyelid dysfunction.7.13 patients accepted magnetic resonance imaging techniques.12 of them showed the "humming bird sign" and 11 of them showed the "mickey mouse sign".The shape of the superior border of the midbrain was depicted.There is only one patients whose border is convex,9patients flat and 3 patients concave. There is no significant differences between two types.The average area of the midbrain is 102.84±23.47mm2,and the ratio between the area of midbrain and pons is 0.22±0.05.Conclusions:Progressive supranuclear palsy is clinically rare, and the symptoms are not typical.So it is difficult to be diagnosed early and easily confused with idiopathic Parkinson’s disease and other Parkinson’s syndrome.Medical history.physical examination and imageological examination is needed To establish a diagnosis of PSP.The rating scale is also helpful to monitor the processing and prognosis of the disease. Different types of PSP show distinct initial symptoms and there are also difference among types.To compare the similarities and differences between the Richardson’s syndrome and PSP-parkinsonism can improve our knowledge and diognosis of PSP.And to improve the understanding of the diseaseand to avoid misdiagnosis is particularly important.Early diagnosis and early treatment is benifit to prolonging the life of the patients and improving the level of the patient’s life quality. |
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