Diversified psychiatric presentation in a case of progressive supranuclear palsy

Progressive supranuclear palsy (PSP) is an unusual neurodegenerative disorder with variant clinical phenotypes. Accurate diagnosis is challenging in the early stage, especially in psychiatric clinics, where misdiagnoses with psychiatric illness are common. A case of PSP was difficult to differentiate from other Parkinsonian syndromes initially, and the patient's affective symptoms predated the onset of other symptoms. Gaze abnormality and frontal lobe syndromes emerged and she was diagnosed with PSP 5 months after the first psychiatric visit. Heightened awareness of PSP and its diagnosis are important, not only because of prognostic implications, but also because of appropriate interventions and focused therapeutic targets.