PSP Association
5,199 members7,196 posts

Stages of psp

Sister in nursing home with parkinsons plus quering psp. My sister over the past 2/3 weeks she has become very very unresponsive and not communicating just staring wide eyed and not looking directly at anyone,very distressing for the family and I am not coping to well with it.Can anyone say if this is another stage or will she come round again.she looks very vacant and at first you think she does not recognise you.Hope someone can help identify this for me.

6 Replies



two years.


Hi nannygoon

If your sister has been provisionally diagnosed with PSP, then the "wide-eyed stare" is a common feature and description of many PSP sufferers. It used to be called the Procerus sign, after the name of a facial muscle that goes into spasm, but this has been abandoned as a description because several muscles in the face are involved (often causing vertical wrinkling of the forehead).

In classical Parkinson's, they describe the expression as a "Blank Stare".

PSP is a progressive disease that displays many symptoms where some are absent at onset, and later appear as the disease progresses. Some of the symptoms that appear early may be "mild" and most (but not all) will increase in their severity as time goes on.

I doubt if she will "come round again", as you ask. There may be intermittent periods when she may communicate somewhat again, but these rarely last for long periods of time.

Let's remember that while PSP has the symptoms you describe, there are other closely related neurological conditions that show similar symptoms (e.g. CorticoBasal Degeneration). It's possible to have PSP and have some symptoms of these other conditions. Additionally, other co-morbidities can exist with overlapping symptoms (e.g. Alzheimer's).

Perhaps you'll need more information from the neurologist who may have originally diagnosed your sister.

Remember, if it's PSP (the type called Richardson's syndrome), then she will always be aware of her surroundings and those who talk to her, even if she cannot communicate and looks vacant. Her brain will be unable to process "word finding" quickly and even when she finds the words, her throat and mouth muscles may not be able to mechanically sound the words.

All the best.

1 like

Thank you for your prompt reply it was very helpfull,as I sometimes feel very alone dealing with my Sister she is 15 years older than me (79) and the roles have now reversed in our life as I now look after her.


Nannygoon, as Strelley said above, the stages are not a straight line. Here is a link to something you may find helpful. Christine47


Hello Nannygoon, I'm in the US but learn so much with the UK people on this site. My mom is 85 and has the blank stare, and her eyes have become so dark, hollow. When speaking to her I can almost see the "wheels turning" as she processes the conversation and responses. It's very sad, but please know you are not alone. We are all here (worldwide!) to help you.


You may also like...