, Volume 253, Issue 3 Supplement, pp iii2-iii15

The diagnosis of multiple system atrophy

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The diagnosis of multiple system atrophy (MSA) in life rests on clinical history and neurological examination. An accurate pre-mortem diagnosis of MSA is important because of prognostic and therapeutic implications. Consensus diagnostic criteria have been developed, but their use does not always improve recognition of MSA, particularly in early disease stages. A range of warning signs (red flags) may point towards MSA. However, their predictive value has never been determined prospectively. Additional investigations such as autonomic function tests, sphincter electromyography, or neuroimaging may be used to support the diagnosis or to exclude other diseases.