Acute PSP-like Syndrome Due to Paramedian Thalamopeduncular Infarction

We report a case of acute pseudo–progressive supranuclear palsy caused by a paramedian thalamopeduncular infarct. The patient presented with a sudden vertical gaze palsy, staring look, and postural instability, mimicking progressive supranuclear palsy. Magnetic resonance imaging showed an acute medial thalamic infarct extending into the midbrain, confirming a vascular etiology.