[Progressive supranuclear ophthalmoplegia--a clinical entity?]

The syndrome of progressive supranuclear ophthalmoplegia (Richardson-Steele-Olszewski-Syndrom) and its relation to other syndromes are discussed on the basis of a number of case histories and a survey of the pertinent literature. The validity of vertical ophthalmoplegia as a pathognomonic symptom is questioned. The main symptoms are as follows: the heightened tone of the neck muscles, as a rule combined with other indications of parkinsonism and an inclination to fall down. To varying degress there are also bulbar signs and subcortical dementia. Neuropathologically the syndrome can be classed with the "multiple system degeneration" group, on which little enough is known. It remains an open question whether the syndrom of Richardson-Steele-Olszewski is a syndrome of its own or whether it is just a variety of parkinsonism.