A 76 year old male comes with a history of frequent falls and difficulty in looking downwards and laterally. The diaganosis is
Alzheimer's disease
Supranuclear palsy
Amyotropic lateral sclerosis
Oculomotor nerve nerve palsy
Ans. is 'b' i.e.,. Supranuclear palsy. Progressive Supranuclear palsy is also known as steel Richardson syndromeIt's a degenerative disorder as their occurs loss of neurons in parts of C.N.S. which are involved with maintenance of posture and equilibrium namely.Mid brainPonsBasal ganglionCerebellumC/F are characteristic" Progressive Supra nuclear palsy should be considered whenever a middle aged or elderly person presents with history of repeated falis and has an extrapyramidal syndrome accompanied by nuchal Dystonia and paralysis of voluntary/' Downgaze.Factors which distinguish this from Parkinson's disease are -Marked impairment of voluntary Downward gaze and horizontal gaze .Extended rather than flexed dystonic postureAbsence of Tremor .Poor response to Antiparkinsonian medication .
C.N.S.