Progressive Supranuclear Palsy

A 60-year-old man presented with a 2-year history of progressive difficulty in walking, with occasional unprovoked falls, especially in the backward direction which occurred while walking, sitting without support and getting up from a chair. Family members reported a constant staring expression, reduced volume and output of speech, and change in behaviour—disinterest in routine activities and occasional inappropriate laughing or crying. There was no history of tremor. There was also a history of occasional difficulty swallowing liquids, choking, and spillage of food while eating. There was no family history of Parkinsonism. Though the patient was started on dopaminergic medications, there was no significant improvement.