Key differences in symptoms and signs in PSP and Parkinson’s disease
| PSP | Parkinson’s disease | |
| Symmetrical | Yes | No |
| Rigidity | Axial | Limb |
| Akinesia | Severe, global Even in loose limbs | Mild to moderate |
| Tremor | No | Yes |
| Falls | Early, spontaneous | Late, with freezing |
| Eyes | Vertical paresis | Normal* |
| Voice | Dysarthrophonia, distorted, poor volume control | Hypophonia, quiet |
| Cognition | Marked early executive changes Loss of fluency | Subtle early executive changes or later dementia |
| Levodopa | Poor response | Very good response |
| Gait | Head up, sniffing the air Leaning back | Head down, stooped, leaning forward |
| Looks like Parkinson’s? | No | Yes |
Bold text highlights the simplest quick-six to have in mind.
* Subtle oculomotor abnormalities occur
PSP, progressive supranuclear palsy.