ESTABLISHMENT OF MEDICAL CARE AND SOCIAL SERVICE FOR PATIENTS WITH PROGRESSIVE SUPRANUCLEAR PALSY:TOHOKU BLOCK COLLABORATIVE STUDY

• Published in: Japanese Journal of National Medical Services Vol. 57; no. 8; pp. 503 - 507
• Main Authors: ONODERA, Jun-ichi, SUZUKI, Hiroyoshi, TOBITA, Muneshige, KOBAYASHI, Akira, TIDA, Keiji, TAKADA, Hiroto, MIYAZAWA, Yukihito, SEKI, Hareaki, KONNO, Hidehiko, AIDA, Takashi, KAMEYA, Takeshi, YOSHIOKA, Masaru, Mamoru, DOI, NOMURA, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 2003; 一般社団法人 国立医療学会
• Subjects: medical care; progressive supranuclear palsy; social service and support system; 医療・福祉資源; 療養環境; 進行性核上性麻痺
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.57.503

Progressive supranuclear palsy (PSP) is one of the most common atypical parkinsonian syndrome characterized by early onset postural instability with falls, vertical supranuclear palsy and symmetrical akinesia or rigidity. In Japan, sufficient epidemiological study of PSP has not been performed due to lack of suitable criteria for diagnosis. Recently, clinical criteria for the diagnosis of PSP were proposed by the “Multicentric Clinical Research Studies on the Prevention, Diagnosis and Treatment of Neurological Diseases” group. We validated the specificity and sensitivity of the criteria by using neuropathologically confirmed cases and surveyed the medical care, social service and support system for patients with PSP. Among neuropathologically confirmed cases of multiple system atrophy (n=4), Parkinson's disease (n=8), dementia with Lewy bodies (n=4) and corticobasal degeneration (n=1), no cases satisfied the criteria. Neuropathologically confirmed cases of PSP (n=7) satisfied the criteria without exception, suggesting that the criteria is useful for epidemiologic study or clinical research. Using this criteria, we studied the conditions of the illness, utilization of medical or social services for patients with PSP. Our study showed that the characteristic conditions of patients with PSP was short duration of the illness and a high percentage of deteriorated ADL requiring medical care in hospital. Some clinical problems of the support system which need to be resolved to provide appropriate medical care, health care, and welfare services are discussed.