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PSP Association
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Does PSP always show on MRI?

Hello all,

My mom has had severe arthitris and is now under treatment to dicrease inflammation. However lately she’s been having more and more neurologic issues : falls, difficulty of speech, apathy, cries like a baby at random times, incontinence, shaky right hand (can no longer write) and after a year of using a cane she is now in a wheelchair or has to be assisted to walk at home otherwise she can’t. We saw 2 neurologists, she’s had MRIs, scans, lumbar puncture. With no obvious imagery/indicator of a neuro disease, doctors claim her issues are all due to her inflammatory autoimmune disease which now attack her brain. They are now continuing her anti-inflammatory treatment to help but it seems to get worse.

I guess my question is: does PSP always show on imagery or lumbar puncture results? All her symptoms scream PSP to me as I’ve witnessed her cognitive ability decrease for a year and now she can’t even walk. She is 62 but she now seems 92. Would you advise we seek a third opinion?

Thanks,

Cecile from Paris, France

17 Replies
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Unfortunately no...MRI may show something to indicate PSP but not always. The ONLY definite diagnosis is from a brain autopsy. Most diagnosis are observational based on symptoms.

Ron

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There isn’t really any test to prove PSP other than after death brain cell examination. An MRI might show the hummingbird pattern in the brain where the brain cells have died. I don’t remember if Larry’s MRIs showed it or it or not. We saw a movement disorder neurologist who first said Parkinsonism then PSP on a follow up visit.

There is also this to look at for symptoms:

pspassociation.org.uk/app/u...

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Hi Cecile

Agreeing with Jeff and Ron.

However an MRI scan will show brain depletion and though it might not show PSP 'signature patterns' in the early stages it will show depletion which might highly suggestive of a diagnosis.

In other words through not definitive, it might be quite helpful.

This is something to talk about with your neurologist. They are the ones doing the scan and given variations in the disease development and the possible certainty of the results, they are the best folk with which to discus what that scan shows.

Hope this helps

Best to you

Kevin

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Have you discussed this with her rheumatologist. I have had rheumatoid Arthritis for over 30 years and at its worst I suffered similar symptoms. I was one of the first people to be given anti TNF injections, my pain disappeared within three days and I have been ok ever since. Maybe the rheumatologist should discuss your mum's symptoms with her neurologist.

Hope you find the correct diagnosis and satisfactory treatment.

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Hi Ccefrance!

Based on various articles, publications and comments in this chat I have been compiling the very varied and erratic symptoms of PSP disease as a function of time. It's a bit long for a chat so I send it to you by private internal mail.

Regards and luck.

Luis

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Cecile,

Our neurologist in the USA was able to supplement the MRI with other PET scans to identify areas of increased levels of amyloid and tau proteins to better diagnosis the disease. This information along with the physical symptoms is how he was able to diagnosis my wife’s CBD. These PET scans are prohibitively expensive and not covered by our insurance schemes in USA. The neurological specialist primarily does research and had access to the PET scans because of the research.

Good luck helping obtain the correct diagnosis,

Bobby

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The best scan for psp is one using photon emission from a radioactive dye injected into the bloodstream

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And I would almost put a bet you could knock one up in your garage!

:)

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Please emai me at keiko27@gmail.com - my dad has psp and i have some info to share with you.

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Hi keiko

It's not awfully wise to post your email publicly. Scammers and malware bot computers scan forums for them.

Best to you

Kevin

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Thank you. I was trying to help. Didnt think about that. But thank you!

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No worries... It's kind of you to help too.

You can use private chat (see the icon at the top of the screen. Only the recipient and moderators can see chats.

If you click on 'more' just under your post you can edit out the email address.

Oh, and thanks for heads up on the Alex Klein videos. Really good :)

Best to you

Kevin

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I have some more info to share. I might do a post. I have been really busy reading about this disease and so many others that affect the brain. I feel like it's my duty to help people as a librarian and as a person and as the daughter of someone who suffers from this condition. Thank you for your help! :)

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Great - Thank you.

When you have time... I'm sure the posts will be well received.

:)

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I just did a post. Hope people reach out. Thank you Kevin!

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Hi there, just going on what our Neurologist told us, a MRI show shrinkage in the brain, showing signs of eye problems, usually the falls are backwards, normally no tremors, so hard when all tests sometimes comes out negative results, yes I would go for a third opinion. Wish you well. Nettie

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Hello Cecile,

Just to agree with what others have said, our specialist neuro said that the MRI can show PSP if you get the hummingbird sign, but that it often doesn't. He insisted that the main use of the MRI was to rule out physical causes like stroke, etc.

Best to you.

Lost

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