Progressive supranuclear ophthalmoplegia. Association with cricopharyngeal dysfunction and recurrent pneumonia

PROGRESSIVE supranuclear ophthalmoplegia (PSO) was found to be the underlying cause of cricopharyngeal dysfunction and secondarily of recurrent pneumonia in an elderly patient. The purpose of this report is to call attention to a treatable cause of recurring pneumonia in the elderly. Report of a Case A 75-year-old man was admitted to the New York Hospital in January 1974 for treatment of acute pneumonia. During the two preceding years, he experienced dysphagia and a 23-kg weight loss and required two hospital admissions because of recurrent episodes of bronchitis and pneumonia. During one of these admissions, the diagnosis of PSO was suggested strongly by the presence of supranuclear ophthalmoplegia, dysarthria, dysphagia, dystonic rigidity, bradykinesia, and a mildly ataxic gait. His past medical history included peptic ulcer disease (treated with a partial gastrectomy and an end-to-side gastrojejunostomy), Laennec cirrhosis, and nonmetastatic prostatic adenocarcinoma. A history suggesting Raynaud phenomenon was later elicited, but