Progressive supranuclear palsy (PSP) (Steele-Richardson-Olszewski syndrome):
Most common ‘parkinsonism-plus syndrome’; neurodegenerative disease resulting in neuronal cell loss, gliosis and neurofibrillatory tangles in midbrain; onset usually in 70’s; M2x>F; no family history; cause unknown; develop ‘downgaze’ of eyes (cardinal feature), frontal lobe signs, peudobulbar palsy, parkinsonism, dystonia, eyelid abnormalities; gait and balance more involved than in Parkinson’s disease (falls are a common presenting feature); foot dystonia in advanced stages can occur; levodopa usually ineffective, but is usually tried.
Restless legs common:
http://www.sciencedirect.com/science/article/pii/S0022510X1500043X
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