Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski]
ICD-10 G23.1 is a billable code used to indicate a diagnosis of progressive supranuclear ophthalmoplegia [steele-richardson-olszewski].
Progressive supranuclear ophthalmoplegia (PSP) is a rare neurodegenerative disorder characterized by the gradual onset of vertical gaze palsy, postural instability, and cognitive decline. It primarily affects the brainstem and basal ganglia, leading to significant motor and non-motor symptoms. Patients often present with symptoms resembling Parkinson's disease, including rigidity, bradykinesia, and postural instability, but PSP is distinct in its early onset of eye movement abnormalities and lack of significant tremor. The condition progresses over time, resulting in severe disability and a reduced quality of life. The pathophysiology involves the accumulation of tau protein in neurons, leading to neurodegeneration. Diagnosis is primarily clinical, supported by neuroimaging findings that may show atrophy of specific brain regions. Treatment focuses on symptomatic management, including dopaminergic medications, which may provide limited benefit, and supportive therapies to improve quality of life.
Comprehensive neurological examination findings, including eye movement assessments and cognitive evaluations.
Patients presenting with unexplained falls, vertical gaze palsy, or cognitive decline.
Documenting the timeline of symptom progression and response to treatment is crucial for accurate coding.
Detailed history of functional decline and comorbidities, including assessments of daily living activities.
Older patients with atypical parkinsonism and cognitive impairment.
Consideration of polypharmacy effects and comprehensive geriatric assessments.
Used for follow-up visits for patients with PSP to assess symptom progression and treatment response.
Detailed history of symptoms, examination findings, and treatment plan.
Neurologists should document neurological assessments thoroughly to support the visit level.
The primary symptoms include vertical gaze palsy, postural instability, cognitive decline, and other movement disorders such as rigidity and bradykinesia.
