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The problems with a diagnosis is there is not any clinical tests at the moment. There are not any blood tests available and imaging only has the effect, really, of ruling out other causes. The main diagnosis is made by taking a detailed clinical history, and as time goes on, and the signs and symptoms become more apparent, then a firm diagnosis can be made. The chart that the PSP Society has produced is very valuable to be in A&E, to be in... With the paramedics and the GP surgery, just to make them aware of some of the signs and symptoms that could be associated with PSP, to point them in that direction. I think this is like for a paramedic who goes out to see Mrs Jones, who has fallen a hundred times, instead of just picking her up and taking her to a hospital, think, "We have gone out to you a lot. How are you falling? Why are you falling? Maybe it is not that you have got whatever you have got." Just because somebody has got a diagnosis, it does not mean it is the right one.

And that is why all the information from people going in, from care assistants, going in from OTs, physios, to pool that information because then you can get a bigger, better picture. As this disease progresses, diagnosis is often clearer. People may present with more frequent falls and be referred through to the emergency services a lot more, and this may then be referred on to a neurologist, and it will be picked up. The eye gaze may become a more serious problem with the supranuclear gaze palsy, that will be an indicator that it is PSP.