Multiple Sclerosis

Key points

• Multiple system atrophy (MSA) is an atypical parkinsonian syndrome. A key exam discriminator: whilst postural hypotension may occur in Parkinson's disease, prominent EARLY autonomic failure together with an ataxic gait points to MSA · MSA also responds poorly to levodopa.
• 1) MSA-P - Predominant Parkinsonian features
• 2) MSA-C - Predominant Cerebellar features Shy-Drager syndrome is a type of multiple system atrophy. Features
• autonomic disturbance o erectile dysfunction: often an early feature o postural hypotension o atonic bladder