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A semiquantitative distribution of neurofibrillary tangles is the basis for the diagnosis of PSP.A high density of neurofibrillary tangles and neuropil threads in the basal ganglia and brainstem is crucial for the diagnosis of typical PSP.Tau-positive astrocytes or their processes in areas of involvement help to confirm the diagnosis.Atypical cases of PSP are variants in which the severity of distribution of abnormalities deviates from the typical pattern.Criteria excluding the diagnosis of typical and atypical PSP are large or numerous infarcts,marked diffuse or focal atrophy,Lewy bodies,changes diagnostic of Alzheimer's disease, oligodendroglial argyrophilic inclusions,Pick bodies,diffuse spongiosis, and prion protein-positive amyloid plaques.The diagnosis of combined PSP is proposed when other neurologic disorders exist concomitantly with PSP. |
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