Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
J Parkinsons Dis. 2022;12(7):2277-2281. doi: 10.3233/JPD-223357.
Multiple system atrophy (MSA) is a rare, rapidly progressive neurodegenerative disorder of the adulthood, characterized by autonomic failure, parkinsonian and cerebellar features in various combinations. Distinguishing MSA from common clinical look-alikes such as Parkinson's disease, other atypical parkinsonian disorders or alternative causes of sporadic adult-onset cerebellar ataxia may be difficult, especially at early disease stages. Nonetheless, some simple and cost-effective screening tools help detecting important red flags guiding towards a MSA diagnosis. Here we outline which clinical pearls and bedside tests may disclose autonomic dysfunction in multiple domains, enabling an early MSA diagnosis and, even more importantly, personalized treatment.
多系统萎缩（MSA）是一种罕见的、进行性迅速的成年期神经退行性疾病，其特征是自主神经衰竭、帕金森病和小脑特征以各种组合出现。将 MSA 与常见的临床类似物（如帕金森病、其他非典型帕金森病或散发性成年期小脑共济失调的其他原因）区分开来可能具有挑战性，尤其是在疾病早期阶段。尽管如此，一些简单且具有成本效益的筛选工具有助于发现指向 MSA 诊断的重要标志。在这里，我们概述了哪些临床要点和床边检查可能会揭示多个领域的自主功能障碍，从而实现早期 MSA 诊断，甚至更重要的是实现个体化治疗。
