<s>[INST] context: * In supranuclear gaze palsy, the difficulty would be with VEICAL GAZE (can't look down) | Causes recurrent falls in the patients Progressive Supranuclear gaze palsy (PSP)/Steele-Richardson-Olszewski syndrome Atrophy of MIDBRAIN (Not pons) Neck position would be flexed backwards k/a RETROCOLLIS (Prominent Neck Dystonia) Supranuclear opthalmoplegia (damage to the sup. Colliculus which affects the GAZE) Pseudobulbar palsy causes swallowing problems Poor response to Levadopa i.e features of Parkinsonism (Bradykinesia, Akinesia) Backward postural falls Physical examination Poor postural reflexes, axial rigidity greater than appendicular rigidity, a dysahria (monotone with slight hypophonic quality) Absence of cogwheeling or tremor Widely based and unstable gait Bradykinesia with masked facies and a staled expression Retrocollis may be present. Special findings: Atrophy of the midbrain (see the image below) with cisternal and ventricular dilatation Thinning of the quadrigeminal plate Dilation of the third ventricle A nonspecific finding of increase in proton density images in the periaqueductal gray matter, compatible with gliotic changes. On Electro-oculography - Square wave jerks MRI Head - Humming Bird appearance [/INST] question: Which among the following is not a feature of Progressive supranuclear gaze palsy? | options: A: Atrophy of midbrain and pons B: Axial rigidity greater than appendicular rigidity C: On Electro-oculography there is Square wave jerks D: On MRI of Head , there is Humming Bird appearance | answer: A </s>