Hummingbird Sign

[Khartt]

I've read all I can find on the hummingbird sign/PSP, but I can't find out WHEN the hummingbird sign is visible ?? Husband had four MRI scans over the last 5 years when his symptoms began , three were said to be normal ( now I wonder). Forth one was reviewed by Movement specialist last January and he pointed out the hummingbird sign .

So does anyone know if it is visible early, by middle years, or later in the disease?

We've been told he's 5/6 years in, just now showing vertical gaze palsy. He can still talk and eat with assistance, and he can walk a little uses the wheelchair now all the time because of 60+ falls this year (impulsivity).

Thanks for input

[rriddle]

it can appear even in the early stages of PSP. but it does NOT ALWAYS appear on an MRI.

[Dadshelper]

As stated it's like other symptoms, not all patients will show it.

Ron

[AnneandChris]

Dear Khartt

It sounds as though your Husband and mine are in a similar position on their journey with PSP. Chris was diagnosed just over three years ago about six months after I rang the warning bells with our doc.

Until joining this site I'd never heard of the humming bird signs so an equally interested to hear more.

Keep on keeping on!

Anne

[NHGrace]

Unless I’m mistaken, a trained neurologist should in fact be able to identify the hummingbird on the MRI of anyone with PSP by the time they are having enough symptoms to be seeking medical evaluation. While my mom’s first sign was probably balance related, a PT identified the vertical gaze palsy when she failed an ocular motor exam. The only MRI (done at the same time) clearly showed the hummingbird.

[Khartt]

Thanks for the replies. I guess I'm like a lot of you trying to figure out where we are in the course of the disease. It's not something I dwell on, just trying to understand. I thought maybe it took some time for the damage/atrophy to be enough that it presented the hummingbird.

#1 neurologist (elder) said nothing "organic"was wrong with him, all tests were normal, he was just grumpy - that was 5 years ago

#2 neurologist (she was more progressive and aggressive ) said it looked like Parkinson's Plus, possibly Lewy body or FTD or PSP. MRI was normal but he was having balance, problems word finding, dry eye, and personality issues. That was 4 years ago.

#3 neurologist at major university hospital said he was leaning toward Parkinson plus/PSP , said MRI was normal

#4 Three months later referred to Movement specialist , same MRI plus DATSCAN, he pointed out hummingbird and diagnosed PSP based on test results , physical exam, reduced blink.

He was never thought to have Parkinson's.

Had eye problems three years ago, but vertical gaze problems just starting.

I'm so glad we can learn from each other!

[wear1947]

Hi Khartt, my sister was diagnosed with PSP-P, last year after 10 years diagnosed with Parkinson and 3 years with the first symptoms (Anxiety, bad sleeping, etc.). She has 4 or more MRI and dynamic PET, the neurologist has never find a humming bird image. I have asked about it. Could be it is not easy to visualize.

Try to stay calm, I know the care giver feels the anxiety of the unknown.

Hugs

[JA10]

Hi, in the UK my Mum has only ever seen one neurologist and he diagnosed by symptoms 3 or 4 years ago, the gaze, though slight then and a fall back test he conducted (stood behind her and pulled back sufficiently to make her fall backwards, she did not step back to stop herself as I would have done, he caught her).

More recently she has participated in some research and one of the elements was an MRI scan. I was able to see the result by the very thankful researcher, the humming bird was really clear, I have a photo on my phone but no idea how to post!

If you want to look at generic scans there are versions online, look at normal brain scans (side way view) then compare with PSP version. The humming bird is in the middle and it really shows why some things become impossible for sufferers, the bit of the brain that controls that movement is just not healthy still. Julie