Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
Correspondence to: Alessandra Fanciulli, MD, PhD, Department of Neurology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria. Tel.: +43 512 504 83238; E-mail: [email protected].
Abstract: 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.
Keywords: Dysautonomia, multiple system atrophy, neurogenic bladder, orthostatic hypotension, parkinsonian disorders, vasomotor control