Progressive supranuclear palsy-like syndrome induced by amiodarone and flunarizine.

Dr. James Pitágoras de Mattos – Rua Santa Clara 50 / 702 22041-012 Rio de Janeiro RJ Brasil. E-mail: [email protected] Progressive supranuclear palsy (PSP) is a taupathy of unknown etiology, representing 7.5% of all cases of Parkinsonism and 50% of atypical Parkinsonism. It was first described as a clinicopathological entity by Steele, Richardson and Olszewski in 1964. Clinically, PSP must be considered in any levodopa-unresponsive parkinsonian patient at middle-to-late age with progressive unexplained prominent postural instability with falls and supranuclear vertical gaze palsy. The latter is characterized by limitation of upward, downward or lateral gaze, mainly downward. Other features are also important, such as: astonished face, retrocollis, lid freezing, monotonal speech, disartria, dysphagia, dementia and sloppy eaters. We report a patient with signs and symptoms suggestive of PSP who markedly improve six months after discontinuation of amiodarone and flunarizine.