MSA-cerebellar feature

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Multiple system atrophy cerebellar type clinical features authoritative

MSA-C (multiple system atrophy, cerebellar type) presents predominantly with:
  • Progressive gait and limb ataxia
  • Dysarthria and scanning/quivering speech
  • Nystagmus or other abnormal eye movements
  • Dysphagia
  • Often pyramidal signs such as hyperreflexia or extensor plantar responses
  • Concomitant autonomic failure: orthostatic hypotension, urinary urgency/retention or incontinence, erectile dysfunction, constipation
  • Parkinsonism can occur later, usually with limited levodopa response
MRI may show pontocerebellar atrophy and the pontine “hot-cross-bun” sign. MSA-C was formerly called olivopontocerebellar atrophy. The NINDS MSA overview similarly highlights ataxia, dysphagia, speech disturbance, and abnormal eye movements as key MSA-C features.
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