How is progressive supranuclear palsy (PSP) diagnosed?

PSP is diagnosed on the basis of clinical signs and exam findings, but it often isn’t easy to diagnose. There’s no single test that points right at it with certainty. It is often mistaken for Parkinson’s disease (PD) and it can sometimes take years to distinguish PSP from PD.

If your healthcare provider suspects PSP based on the symptoms you report, he or she will likely send you to get a MRI (magnetic resonance imaging). This will help to rule out other diseases such as Parkinson’s and occasionally it can show shrinking of your midbrain that raises the possibility of PSP in the appropriate clinical setting. You’ll also be sent to a neurologist specializing in Parkinson’s disease and movement disorders.

Although there are many symptoms of PSP, the one that confirms the diagnosis is trouble moving your eyes up and down. Other common symptoms like falling and difficulty swallowing also point at PSP.

Do I need to see a specialist?

Yes. A movement disorder neurologist can confirm the diagnosis of PSP with the highest level of certainty.

What questions might my healthcare provider ask to diagnose progressive supranuclear palsy?

  • Are you having falls you can’t explain?
  • Are you falling backward?
  • Are your muscles stiff?
  • Are you talking normally or have you noticed changes in your speech?
  • Are you feeling depressed?
  • Are you still enjoying the same activities you always have?
  • Are you sleeping normally?
  • Are you overly irritated or aggravated?

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy