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Abstract：
BACKGROUND: Progressive supranuclear palsy (PSP) is a syndrome characterized by progressive parkinsonism with early falls due to postural instability, typically vertical gaze supranuclear ophthalmoplegia, pseudobulbar dysfunction, neck dystonia and upper trunk rigidity as well as mild cognitive dysfunction. Progressive supranuclear palsy must be differentiated from Parkinson\'s disease taking into account several so-called red flags.
METHODS: We report a case series hallmarked by gait abnormalities, falls and bradykinesia in which Parkinson\'s disease was the initial diagnosis.
RESULTS: Due to a torpid clinical course, magnetic resonance imaging (MRI) was performed demonstrating midbrain atrophy, highly suggestive of progressive supranuclear palsy.
CONCLUSIONS: The neuroradiological exams (magnetic resonance imaging, single photon emission computer tomography, and positron emission tomography) can be useful for diagnosis of PSP. Treatment with levodopa should be considered, especially in patients with a more parkinsonian phenotype.
METHODS: We report a case series hallmarked by gait abnormalities, falls and bradykinesia in which Parkinson\'s disease was the initial diagnosis.
RESULTS: Due to a torpid clinical course, magnetic resonance imaging (MRI) was performed demonstrating midbrain atrophy, highly suggestive of progressive supranuclear palsy.
CONCLUSIONS: The neuroradiological exams (magnetic resonance imaging, single photon emission computer tomography, and positron emission tomography) can be useful for diagnosis of PSP. Treatment with levodopa should be considered, especially in patients with a more parkinsonian phenotype.
摘要：
背景：进行性核上性麻痹（PSP）是一种以进行性帕金森病为特征的综合征，由于姿势不稳定而导致早期跌倒，典型的垂直凝视核上眼肌麻痹，假性球功能障碍,颈部肌张力障碍和上躯干僵硬以及轻度认知功能障碍。进行性核上性麻痹必须与帕金森氏病区分开来，同时考虑到几个所谓的危险信号。
方法：我们报告了一个以步态异常为特征的病例系列，跌倒和运动迟缓，其中帕金森病是最初的诊断。
结果：由于临床过程艰难，磁共振成像（MRI）显示中脑萎缩，高度怀疑进行性核上性麻痹。
结论：神经放射学检查（磁共振成像，单光子发射计算机断层扫描，和正电子发射断层扫描）可用于PSP的诊断。应考虑使用左旋多巴治疗，尤其是在具有更多帕金森病表型的患者中。
方法：我们报告了一个以步态异常为特征的病例系列，跌倒和运动迟缓，其中帕金森病是最初的诊断。
结果：由于临床过程艰难，磁共振成像（MRI）显示中脑萎缩，高度怀疑进行性核上性麻痹。
结论：神经放射学检查（磁共振成像，单光子发射计算机断层扫描，和正电子发射断层扫描）可用于PSP的诊断。应考虑使用左旋多巴治疗，尤其是在具有更多帕金森病表型的患者中。
