Patient presents with clinical features suggestive of Progressive Supranuclear Palsy (PSP).  Symptoms include progressive postural instability with falls, supranuclear gaze palsy particularly affecting vertical gaze, axial rigidity, and cognitive impairment.  The patient exhibits difficulty with balance and gait, demonstrating a tendency to fall backward.  Ophthalmologic examination reveals slowed vertical saccades and limited upward gaze.  Neck rigidity and stiffness are noted, contributing to the patient's postural difficulties.  Cognitive assessment indicates executive dysfunction, including difficulties with planning and problem-solving.  Symptoms align with the Movement Disorder Society clinical diagnostic criteria for probable PSP.  Differential diagnosis considered Parkinson's disease, corticobasal degeneration, and multiple system atrophy.  Current treatment plan focuses on symptomatic management, including physical therapy for balance and gait training, occupational therapy for adaptive strategies, and speech therapy for dysarthria if present.  Pharmacological interventions, such as amantadine for rigidity and levodopa for parkinsonism, may be considered, although their efficacy in PSP is often limited.  Prognosis discussed with the patient and family, emphasizing the progressive nature of the disease and the importance of supportive care.  Patient will be monitored for disease progression and treatment response.  ICD-10 code G23.1, Progressive supranuclear ophthalmoplegia, is assigned.