Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature Review
Multiple system atrophy (MSA) is an adult-onset, sporadic, progressive neurodegenerative disease. According to the consensus criteria, patients with MSA are clinically classified into cerebellar (MSA-C) and parkinsonian (MSA-P) subtype. Besides the poor response to levodopa, and the additional prese...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayinevi
2013-03-01
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| Series: | Türk Nöroloji Dergisi |
| Subjects: | |
| Online Access: | http://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-82905 |
| _version_ | 1797912186749714432 |
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| author | Mehmet Yücel Oğuzhan Öz Hakan Akgün Semai Bek Tayfun Kaşıkçı İlter Uysal Yaşar Kütükçü Zeki Odabaşı |
| author_facet | Mehmet Yücel Oğuzhan Öz Hakan Akgün Semai Bek Tayfun Kaşıkçı İlter Uysal Yaşar Kütükçü Zeki Odabaşı |
| author_sort | Mehmet Yücel |
| collection | DOAJ |
| description | Multiple system atrophy (MSA) is an adult-onset, sporadic, progressive neurodegenerative disease. According to the consensus criteria, patients with MSA are clinically classified into cerebellar (MSA-C) and parkinsonian (MSA-P) subtype. Besides the poor response to levodopa, and the additional presence of pyramidal or cerebellar signs (ataxia) or autonomic failure as major diagnostic criteria, certain other clinical features known as ‘‘red flags’’ or warning signs may raise the clinical suspicion of MSA. Case report: A 67-year-old woman was admitted to our hospital due to inability to walk. Neurological examination revealed severe Parkinsonism with poor response to levodopa therapy, ataxia. Brain MR imaging showed severe atrophy of the cerebellum, pons, minimal cerebrum, and revealed cross section at the pons in the axial section. Mini-Mental State Examination (MMSE) was normal, Median SEP within normal limits but left Tibial SEP was longer than right side (right: 41, left: 44.2). Although sympathetic skin response of upper extremities was normal, the sympathetic skin responses of lower extremities were absent. RR interval study and a graded head-up tilt test were consistent with autonomic dysfunction. We report a patient with MSA because in clinical practice a case who fullfits all criteria is really rare. |
| first_indexed | 2024-04-10T11:53:31Z |
| format | Article |
| id | doaj.art-34457b10926e4fb8a6236d24c55cacc4 |
| institution | Directory Open Access Journal |
| issn | 1301-062X 1309-2545 |
| language | English |
| last_indexed | 2024-04-10T11:53:31Z |
| publishDate | 2013-03-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Türk Nöroloji Dergisi |
| spelling | doaj.art-34457b10926e4fb8a6236d24c55cacc42023-02-15T16:17:01ZengGalenos YayineviTürk Nöroloji Dergisi1301-062X1309-25452013-03-01191283010.4274/Tnd.82905Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature ReviewMehmet Yücel0Oğuzhan Öz1Hakan Akgün2Semai Bek3Tayfun Kaşıkçı4İlter Uysal5Yaşar Kütükçü6Zeki Odabaşı7Gülhane Military Medical AcademyGülhane Military Medical AcademyGülhane Military Medical AcademyGülhane Military Medical AcademyGülhane Military Medical AcademyGülhane Military Medical AcademyGülhane Military Medical AcademyGülhane Military Medical AcademyMultiple system atrophy (MSA) is an adult-onset, sporadic, progressive neurodegenerative disease. According to the consensus criteria, patients with MSA are clinically classified into cerebellar (MSA-C) and parkinsonian (MSA-P) subtype. Besides the poor response to levodopa, and the additional presence of pyramidal or cerebellar signs (ataxia) or autonomic failure as major diagnostic criteria, certain other clinical features known as ‘‘red flags’’ or warning signs may raise the clinical suspicion of MSA. Case report: A 67-year-old woman was admitted to our hospital due to inability to walk. Neurological examination revealed severe Parkinsonism with poor response to levodopa therapy, ataxia. Brain MR imaging showed severe atrophy of the cerebellum, pons, minimal cerebrum, and revealed cross section at the pons in the axial section. Mini-Mental State Examination (MMSE) was normal, Median SEP within normal limits but left Tibial SEP was longer than right side (right: 41, left: 44.2). Although sympathetic skin response of upper extremities was normal, the sympathetic skin responses of lower extremities were absent. RR interval study and a graded head-up tilt test were consistent with autonomic dysfunction. We report a patient with MSA because in clinical practice a case who fullfits all criteria is really rare.http://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-82905Multiplesystematrophyautonomicfailurediagnosticcriteria |
| spellingShingle | Mehmet Yücel Oğuzhan Öz Hakan Akgün Semai Bek Tayfun Kaşıkçı İlter Uysal Yaşar Kütükçü Zeki Odabaşı Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature Review Türk Nöroloji Dergisi Multiplesystematrophy autonomicfailure diagnosticcriteria |
| title | Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature Review |
| title_full | Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature Review |
| title_fullStr | Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature Review |
| title_full_unstemmed | Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature Review |
| title_short | Diagnostic Clues in Multiple System Atrophy: A Case Report and Literature Review |
| title_sort | diagnostic clues in multiple system atrophy a case report and literature review |
| topic | Multiplesystematrophy autonomicfailure diagnosticcriteria |
| url | http://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-82905 |
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