Multisystem atrophy Flashcards
1
Q
What is multisystem atrophy?
A
Common cause of degenerative parkinsonism
2
Q
Who gets Multi system atrophy?
A
Late 6th or 7th decades
3
Q
Presentation of Multisystem atrophy?
A
Core triad of
- Dysautonomia
- Cerebellar features
- Parkinsonism
+/-
- Jerky postural tremor, pyramidal signs
- Suboptimal and short- lived levodopa response in 1/3 patients
- Other suggestive features: severe dysarthria or dysphonia, marked antecollis, inspirator sighing, orofacial dystonia
4
Q
What are pyramidal signs?
A
Generalized hyperreflexia and extensor plantar responses
5
Q
Diagnosis of multisystem atrophy?
A
MRI may show cerebellar and pontine atrophy (hot cross bun sign or hyperintense rim surrounding the putamen in T2 weighted sequences
6
Q
What is MSA characterized by?
A
- Parkinsonism
- Autonomic dysfunction
- Erectile dysfunction/urinary urgency
- Cerebellar dysfunction
7
Q
What does this parkinsonism look like?
A
Poor levodopa response
8
Q
What does an MRI of MSA look like?
A
Putaminal atrophy ‘hot cross bun’ pons on axial section
