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Multiple system atrophy. Clinical and MR observations on 42 cases

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Abstract

Probable or possible multiple system atrophy (MSA) was diagnosed on strict clinical criteria in 42 patients: 20 with combined parkinsonism and cerebellar ataxia, 9 with striatonigral degeneration (SND) and 13 with olivopontocerebellar atrophy (OPCA). All patients were then studied with 0.5 and/or 1.5 Tesla magnetic resonance (MR) units. MR imaged putaminal abnormalities in all 9 patients with SND and posterior fossa obnormalities consistent with OPCA in all 13 patients with this diagnosis. Of the 20 patients with parkinsonism and cerebellar involvement, classified as probable MSA, 7 presented putaminal abnormalities only, 3 abnormalities consistent with OPCA only and 10 a combination of both. These findings show strong MRI support for the clinical diagnosis of MSA.

Sommario

In base a precisi criteri clinici 42 pazienti furono riconosciuti affetti da atrofia multisistemica (MSA) probabile o possibile. Venti pazienti presentavano parkinsonismo e atassia cerebellare; in 9 fu fatta diagnosi di degenerazione strio-nigrica (SND) e in altri 13 di atrofia olivopontocerebellare (OPCA). Tutti i pazienti furono sottoposti a risonanza magnetica 0.5 e/o 1.5 T. La RM mostrava alterazioni nei putamen nei 9 pazienti con SND e alterazioni in fossa posteriore come attese nell'OPCA nei 13 casi diagnosticati affetti da OPCA. In 10 dei 20 pazienti con parkinsonismo e atassia cerebellare le alterazioni nei putamen e in fossa posteriore erano associate. I nostri dati confermano che la RM è un supporto diagnostico fondamentale nella diagnosi di MSA.

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References

  1. Brooks D.J., Ibanez V., Sawle G.V. et al.:Differing patterns of striatal 18F-Dopa uptake in Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy. Ann. Neurol. 28:547–555, 1990.

    Article  CAS  PubMed  Google Scholar 

  2. Brooks D.J., Ibanez V., Sawle G.V. et al.:Striatal D2 receptor status in patients with Parkinson's disease, striatonigral degeneration and progressive supranuclear palsy, measured with 11C-Raclopride and Positron Emission Tomography. Ann. Neurol. 31:184–192, 1992.

    Article  CAS  PubMed  Google Scholar 

  3. Cortés R., Camos M., Gueye B. et al.:Dopamine receptors in human brain: autoradiographic distribution of D1 and D2 sites in Parkinson syndrome of different etiology. Brain Research 483:30–38, 1989.

    PubMed  Google Scholar 

  4. Duvoisin R.C.:The olivopontocerebellar atrophies. In: Marsden C.D., Fahn S. (ed.). Movement Disorders 2. London, Butterworths, 249–269, 1987.

    Google Scholar 

  5. Gilman S., Markel D.S., Koeppe R.A. et al.:Cerebellar and brainstem hypometabolism in olivopontocerebellar atrophy detected with positron emission tomography. Ann. Neurol. 23:223–230, 1988.

    Article  CAS  PubMed  Google Scholar 

  6. Graham J.G., Oppenheimer D.R.:Orthostatic hypotension and nicotine sensitivity in a case of multiple system atrophy. J. Neurol. Neurosurg. Psychiatry 32:28–34, 1969.

    CAS  PubMed  Google Scholar 

  7. Hirayama K., Saito M., Chida T. et al.:A clinicopathological study on extrapyramidal components in cerebellar degeneration with special reference to olivopontocerebellar atrophy. Adv. Neurol. Sci. 21:37–54, 1977.

    Google Scholar 

  8. Klockgether T., Schroth G., Dierner H.-C., Dichgans J.:Idiopathic cerebellar ataxia of late onset: natural history and MRI morphology. J. Neurol. Neurosurg. Psychiat. 53:297–305, 1990.

    CAS  PubMed  Google Scholar 

  9. Oppenheimer D.:Neuropathology of progressive autonomic failure. In: Bannister R. (ed.) Autonomic Failure. A textbook of clinical disorders of the autonomic nervous system. Oxford, Oxford University Press 267–283, 1982.

    Google Scholar 

  10. Pastakaia B., Polinsky R., Di Chiro G. et al.:Multiple system atrophy (Shy-Drager syndrome): MR imaging. Radiology 159:499–502, 1986.

    Google Scholar 

  11. Quinn N.:Multiple system atrophy. The nature of the beast. J. Neurol. Neurosurg. Psychiatry; special suppl. 78–89, 1989.

  12. Savoiardo M., Bracchi M., Passerini A. et al:Computed tomography of olivopontocerebellar degeneration. AJNR 4:509–512, 1983.

    CAS  PubMed  Google Scholar 

  13. Savoiardo M., Strada L., Girotti F. et al.:Olivopontocerebellar atrophy: MR diagnosis and relationship to Multisystem atrophy. Radiology 174:693–696, 1990.

    CAS  PubMed  Google Scholar 

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Testa, D., Savoiardo, M., Fetoni, V. et al. Multiple system atrophy. Clinical and MR observations on 42 cases. Ital J Neuro Sci 14, 211–216 (1993). https://doi.org/10.1007/BF02335661

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