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Progressive supranuclear palsy - Complications of progressive supranuclear palsy

Progressive supranuclear palsy (PSP) can have serious complications including choking and pneumonia caused by swallowing problems or injuries caused by falls.


Falls are a common complication of PSP due to the associated problems with balance and vision. They can be very serious as people often fall backwards without warning.

In the most serious cases, falls can cause fractures or head injuries, which can be life-threatening.

The risk of a fall can often be reduced through good care and assistance. Treatment includes the use of walking aids, methods to improve balance and eyesight problems and identifying potential hazards in the home.

Aspiration pneumonia

Aspiration pneumonia can also be a serious complication of PSP. It's a lung infection that's triggered when fluids or small pieces of food enter your lungs.

People with PSP are particularly vulnerable to aspiration pneumonia because their impaired swallowing reflexes mean that their voice box (larynx) doesn't close when they swallow, increasing the risk of food and fluid entering their lungs.

The symptoms of aspiration pneumonia include:

  • high temperature (fever) above 38°C (100.4°F) 
  • fatigue
  • chest pain
  • shortness of breath 
  • blue skin (cyanosis) - due to a lack of oxygen
  • wheezing

You may also have a cough which sometimes produces foul-smelling phlegm and may contain traces of blood and pus.

Contact your care team immediately if you're being treated for PSP and you develop the above symptoms. If this isn't possible, you should contact your local out-of-hours service or call NHS 111.

The symptoms of aspiration pneumonia can range from mild to severe. Severe cases will require hospital admission and treatment with intravenous antibiotics (antibiotics given through a vein).

In particularly vulnerable or frail people, there's a risk that the infection could lead to their lungs becoming filled with fluid, preventing them from working properly. This is known as acute respiratory distress syndrome (ARDS). 

Unfortunately, as most people with advanced PSP are vulnerable and frail, repeated episodes of aspiration pneumonia can sometimes be fatal.

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