09/11/2022
Progressive Supranuclear Palsy
A brief of Progressive Supranuclear Palsy (PSP) with a fantastic testimonial.
Progressive Supranuclear Palsy, also called Steele-Richardson-Olszewski syndrome, is an uncommon brain disorder that causes serious problems with walking, balance, and eye movements. The disorder results from the deterioration of cells in areas of your brain that control body movement and thinking.
Progressive Supranuclear Palsy worsens over time and can lead to life-threatening complications, such as pneumonia and swallowing problems. With Ayurvedic medicines and Panchakarma therapies, we can treat Progressive Supranuclear Palsy, so treatment focuses on managing the signs and symptoms.
Brief with types
PSP is frequently misdiagnosed as Parkinson's disease because of slowed movements and gait difficulty, or as Alzheimer's disease because of the behavioral changes. It is one of several diseases collectively referred to as Parkinson plus syndromes.
Signs & Symptoms (Lakshana):
The initial symptoms in two-thirds of cases are loss of balance especially to the backside, lunging forward when mobilizing, fast walking, bumping into objects or people, and falls.
Other common early symptoms are changes in personality, general slowing of movement, and visual symptoms.
Later symptoms and signs are
• Dementia (typically including loss of inhibition and ability to organize information),
• Slurring of speech,
• Difficulty swallowing
• Difficulty moving the eyes, particularly in the vertical direction.
The latter accounts for some of the falls experienced by these patients as they are unable to look up or down.
Some of the other signs are
• poor eyelid function
• contracture of the facial muscles
• A backward tilt of the head with stiffening of the neck muscles
• sleep disruption
• Urinary incontinence and
• Constipation.
Cardinal manifestations:
• Supranuclear ophthalmoplegia.
• Neck Dystonia.
• Parkinsonism (Parkinsonism is a clinical syndrome characterized by tremors, Bradykinesia, rigidity, and postural instability)
• Pseudo bulbar palsy.
• Behavioural and cognitive impairment.
• Imbalance and walking difficulty.
• Frequent falls.
Points for differential diagnosis from Parkinson’s Disease
On close inspection, eye movements called "square-wave jerks" may be visible when the patient fixes at distance.
The weakness/paralysis of eye muscles experienced by these patients mainly concerns voluntary eye movement and the inability to make vertical saccades (Quick, simultaneous vertical movement of both eyes between two or more phases of fixation in the same direction), which is often worse with downward saccades. Patients tend to have difficulty looking down (a downgaze palsy) followed by the addition of an upgazed palsy.
Difficulties with convergence (convergence insufficiency), where the eyes come closer together while focusing on something near, like the pages of a book, is typical. Because the eyes have trouble coming together to focus at short distances, the patient may complain of diplopia (double vision) when reading.
Causes (Nidana):
The signs and symptoms of the disorder result from the deterioration of cells in areas of your brain, especially those that help you control body movements (midbrain), neurons in Supranuclear area and thinking (frontal lobe).
Researchers have found that the deteriorating brain cells of people with Progressive Supranuclear Palsy (PSP) have abnormal amounts of a protein called tau. Clumps of tau are also characteristic of other neurodegenerative disorders, such as Alzheimer's disease.
Rarely, Progressive Supranuclear Palsy (PSP)occurs within a family. But a genetic link isn't clear, and most people with Progressive Supranuclear Palsy (PSP) haven't inherited the disorder.
• Treatments:
The classical treatment advised for Progressive Supranuclear Palsy (PSP) is Panchakarma.
Ayurveda takes a unique approach to the management by Ayurvedic principles with a special emphasis on eliminating their causes by Panchakarma and medicinal treatment with the help of a wide range of herbal and Herbo-mineral drugs. Ayurveda describes many nootropic drugs (stimulating mental activity, causing cerebral or intellectual activity) and nervous system tonics (i.e., Rasayana in the treatment of Vata diseases). Being a neurodegenerative disease, Parkinson’s disease is treated by Rasayana or the Rejuvinative approach in Ayurveda. Rasayana drugs are essentially nutraceutical agents and Medhya Rasayana is specific neuro-nutrients or nervine tonics with nootropic effects.
Medication
Internal medicines and external applications of medicines play a key role in the treatment of Progressive Supranuclear Palsy. Internal medicines include Kashaya(Decoction), tablets, capsules, Ghruthas(medicated Ghee) Bhasmas, and medicated oils.
Pathya (Dietary Regimens)
Pathya for Progressive Supranuclear Palsy - a nutritious diet:- high fiber food, wheat, jowar, kulatha, masha, til and sarsha (mustred) oil, ghee, milk, lashuna, hingu, ela, and specaily meat of some selective animals.
• Additional Treatment
Physiotherapy
Patients are often referred to physiotherapy to manage their symptoms. Most physiotherapy interventions for PSP include an exercise regimen that consists of
• Aerobic exercises
• Transfer/balance training
• Gait training
• Weighted tool can be used to prevent backward falls
• Flexibility training
• Intensive routines
• Goal oriented tasks
• Visual tracking
• Prism lenses sometimes used to further train gaze
• Motor-cognitive exercises
An exercise program following these guidelines is recommended for about 1-2 hours a day, 5 days a week, to show any significant improvements.
AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY THERAPY
ASLP specialists assess, diagnose, and treat speech, language, social communication, cognitive communication, swallowing difficulties, hearing & imbalance problems using assistive communication devices and change the food consistency to correct the swallowing difficulties. Because if the food gets into the lung, cause aspiration Pneumonia. So, the ASLP specialist helps to prevent this from happening.
NUTRITION & DIETITICS
We have observed that absorption issues can be resolved with the help of a nutritionist. Dietitians assess individuals’ food and nutrient intake, lifestyle, and medical history. Their advice can contribute to the improvement of PD symptoms and increase health-related quality of life. Planning of balanced diet based on periodical nutritional assessments is essential because PD patients present with gastrointestinal dysfunction leading to constipation and Gastroparesis (food remaining in the stomach for a longer period than normal). Diet planning is also needed to maintain nutritional levels by avoiding weight loss or gain.
CLINICAL PSYCHOLOGY
Our psychologist assesses individuals to diagnose their cognitive, emotional, and behavioral disorders and treats them using a variety of techniques, including cognitive behavioral therapy (CBT). They support the patient as well as their relatives.
YOGA AND MEDITATION
Yoga is the science gifted to the world by primordial Indian culture. Yoga aims to unify body and mind by combining respirational and physical exercises. Yoga enhances body movements, cognitive and behavioral problems. More than being a mere exercise regimen, Yoga aims to coordinate bodily functions with that of the mind. Various Yoga techniques help in maintaining peace, confidence, and happiness in the mind while helping to increase flexibility, reduce muscle spasms, and ultimately lead to an improved quality of life.
Prevention
In Ayurveda, A regulated lifestyle, a wholesome diet, appropriate behavior, and following an ideal code of conduct as quoted in Ayurveda are best to prevent and manage neurodegenerative diseases in general and PSP.
