Abstract
A lady with early onset cognitive impairment with movement disorder and elevated mood, grandiosity, distractibility, flight of ideas, pressure of speech presented in outpatient department and initially diagnosed as Bipolar disorder with early onset parkinsonism and Frontotemporal dementia. She later developed vertical gaze palsy with slow saccadic movements and her diagnosis was confirmed as Progressive supranuclear palsy (PSP). The association of bipolar disorder indigenous to pathological laughter and crying is the pearl of this clinical case.
 Key words : PSP, Bipolar disorder, vertical gaze palsy, extrapyramidal symptoms
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