Progressive supranuclear palsy and its relation to pacific foci of the parkinsonism-dementia complex and Guadeloupean parkinsonism.

Steele, Richardson and Olszweski in 1964 described a distinctive clinical and pathological entity they called progressive supranuclear palsy (PSP). Now on Guadeloupe in the Carribbean French West Indies, Caparros-Lefebvre is identifying many patients with similar clinical and histological features. Others have a clinical syndrome of atypical parkinsonism that resembles the parkinsonism-dementia complex (PDC) of Guam and the Kii peninsula of Japan (PDC). But in those Pacific foci the histology is different and the abnormal tau is of Alzheimer's type rather than the PSP type of Guadeloupe. In both locales, neurotoxins of local foods are implicated in etiology. Future studies will confirm if Guadeloupean parkinsonism is truly a geographic focus of PSP, and if dietary factors account for both. Copyright 2002 Elsevier Science Ltd.