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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