DEAR DR. DONOHUE: I have been diagnosed with progressive supranuclear palsy. My balance has become bad, and I have become somewhat confused and can’t think clearly. I read and then don’t understand what I read. I don’t know anyone else with PSP, so I can’t compare my case with theirs. Do you know about this? — K.F.

ANSWER: Few readers recognize the illness progressive supranuclear palsy, PSP. Many remember the actor Dudley Moore. He had it. It’s a newcomer to the catalog of medical illnesses. It comes on between the ages of 45 and 75. One of its unique features is the inability to turn the eyes downward and sometimes upward. People lose their sense of balance. Falls are common because of the loss of balance and because the eyes cannot be turned downward to see the surface one is walking on.

Speaking can become difficult, and swallowing might be impossible. Forgetfulness and mental cloudiness often are part of the picture. Many symptoms are similar to those of Parkinson’s disease, but PSP is not Parkinson’s.

Nerve cells are degenerating in the brain. One spot where that happens is the location called the supranuclear area, which is responsible in part for eye movements.

It’s nearly impossible to predict how rapidly the illness will progress. Medicines used for Parkinson’s disease are also used for PSP, but they are not as effective for PSP as they are for Parkinson’s disease. Glasses with prisms can compensate for the lack of downward eye movement.

You will lose the feeling of not knowing anyone else with this illness if you contact the Foundation for PSP, whose phone number is 800-547-4777 (in Canada, 866-457-4777) and whose website is www.psp.org. The foundation will keep you informed of any breakthroughs in treatment and will become a friend that is there to help you cope with this difficult illness.

DEAR DR. DONOHUE: A few weeks ago you had an article about hepatitis C. My oldest son, 57, has it and has not had any treatment. Will you repeat the information? I can’t find the article. — A.B.

ANSWER: About 80 percent of those infected with hepatitis C virus remain infected for life. Of that number, 20 percent develop liver cirrhosis or liver cancer in 20 to 30 years.

Since only one out of five develops these complications and since it’s difficult to know who will be among that 20 percent, the indications for treatment are important. They include finding the virus’s RNA in the blood and obtaining evidence that the liver is undergoing changes that lead to cirrhosis.

Exciting news about hepatitis C is the approval by the Food and Drug Administration of two new drugs that greatly enhance the prospects of achieving sustained virologic response (a cautious way of suggesting cure). Those two drugs are boceprevir (Victrelis) and telapravir (Incivek). Combining either of those two medicines with the two medicines that have been standard treatment provides great hope for those who are infected.

DEAR DR. DONOHUE: I am 67 and do not wear glasses. I can read newspaper print on my own. However, I have noticed increasing difficulty seeing at night. It’s hard for me to read road signs and street names. Why is this so, when my vision is good during the day? — D.M.

ANSWER: You are a most unusual person with most remarkable vision. Your night-vision difficulty happens to all older people. The pupils of the eye don’t dilate as much as they used to in the dark, so less light gets into the eye. That decreases visual acuity. In addition, the lens of the eye becomes slightly discolored, and that impedes light from reaching the retina.

In all other respects, you are a very lucky person when it comes to eyesight.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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