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Progressive Supranuclear Palsy (also called steele richardson syndrome)

Loss of vertical and then of horizontal gaze
pseudobulbar palsy 
long tract signs
neck rigidity

falls, mental disturbance, slurred speech

reflex eye mvts - neck flexion/extension remain intact
M.F, 45-70yrs, 5-6/100000
no effective Rx - death 5-10yrs
Ldopa may help, Donepezil doesn't help, Good nursing care

pseudobulbar palsy 
degeneration of corticobulbar pathways 5,7,10,11,12 ..... 3,4,6 spared 
so weak chewing and facial expression, difficulty swallowing, brisk gag reflex, immobile tongue
No LMN signs (unlike bulbar palsy - 10,11,12, ??7)