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This is a case of an old man, affected by progressive supranuclear palsy (PSP), admitted due to behavioral alteration in long-term home. Medical background PSP's diagnosis in 2008. Debuts in the form of lower limb tremor, Bradykinesia and tendency to fall. Hypomimia, hypotonia, rigidity and slight postural tremor in upper limbs. Partial response to anti-Parkinson drugs. Psychiatric background, premorbid personality prone to cognitive rigidity, dichotomous thinking and impulsiveness. Join in acute unit from February to May 2012, where it is oriented as a depression of adaptive features. Several antidepressants were tested with partial response (venlafaxine, reboxetine, mirtazapina, bupropion, sertraline). Current episode patient, who comes presenting behavioral alteration with poor tolerance to the limitations imposed by the disease and passive aggressive behaviors. His wife reports difficulties in ambulation, increment of falls, and lack of hygiene and dietary transgression. Complementary explorations blood test: hemogram and biochemical unaltered, hypertriglyceridemia, syphilis, HIV serology negative. Diagnosis stable PSP, behavioral disorders are objectified within his personality disorder. Pharmacological approach. In case levodopa causes clinical symptoms of postural hypotension, stalevo is decreased and sinemet is removed. Slight improvement is noticed. Case review PSP is an uncommon brain disorder that affects movement, control of walking and balance, vision, cognitive impairment and neuropsychiatric disorders. It is associated with the deposition of hyperphosphorylated, tau, in the pallidum, subthalamic nucleus, red nucleus, etc. Cognitive deficits and neuropsychiatric symptoms may precede the onset of Parkinsonism. Most changes are referred to personality, with presence of irritability, impulsivity. Psychotic symptoms may exist. There are no disease-modifying treatments. Management should focus on optimizing life quality.
Disclosure of interestThe author has not supplied his declaration of competing interest.
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