Brain studies. This is a term reserved for conditions that affect the connection between nuclei controlling the eye movements with the centers in the brain usually in the frontal lobes. Inability to look up is a common finding.
Good History & exam! Good history & exam are the keys. In expert hands, that is all you really need. However, a new test/imaging procedure called datscan can determine if the person is suffering from a true Dopamine degenerative state (parkinsonian sundrome) or not, it cannot destinguish b/w these parkinsonian syndromes, however!
Gaze palsy. Meaning, one can't look to the right or left.
Above nuclei. This refers to damage of nervous system structures above the nuclei of affected areas of palsy; typically, this involves those cranial nerves controlling ophthalmic muscles in Progressive Supranuclear Palsy, a neurodegenerative disorder.
Unknown. It is one of the neurodegenerative disease like parkinsonism. So far no exact cause is found.
Tau protein D/O. No, tau protein deposits & neurofibrillary tangles in neurons cause the death of these cells. Because they are in some similar areas as parkinson's disease, psp can appear similar clinically, but there are clear differences. Treatment approaches are roughly the same with different areas needing most attention. Primarily balance/falls/injury, did inhibiting dementia & dysphagia/aspiration.
Not good. Not very much except for supportive care. Doesn't respond well to drugs used for other types of parkinson's.
Good Rx Available!!! Dopamine meds for physical parkinsonism: Azilect (mao-b selective inhibitor) & sinemet +/- Comtan (stalevo (carbidopa and levodopa and entacapone) is both together). Tailor rx & watch for side effects. Avoid Dopamine agonists (requip xl/mirapex er/neupro)--too side effect prone for psp patients. For dementia: namenda, paired with Exelon patch or aricept. For psychosis: seroquel or clozaril. Remember, response is variable, but worthwhile.
The right doctor. I believe it is important to be seen by a movement disorders neurologist for this neurodegenerative disease. This is a very difficult disease to treat. A patient may need very high doses of levodopa. Oftentimes issues such as feeding tubes are at the fore. A specialist will have more experience dealing with this rare disease and may have other options (i.e. Clinical trials) available.
Fair to poor. Fair to poor, depends on how severe it is.
Supranuclear palsy. Unfortunately, no known treatment other than supportive care for supranuclear palsy exists. The average person is in their 60's when diagnosed. Life expectancy averages 7 years after diagnosis.
Falls. Usually starts with falls swallowing difficulties are also seen.
Bad illness. Lose ability to move eyes properly, lose ability to balance and walk, have twisting dystonic posture of spine. Not curable or easily treated, and hope you or family members do not have.