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Neuropathological findings in multiple system atrophy with dystonia

Boesch et al ,1 reporting their experience with dystonia in multiple system atrophy (MSA), observed in 40% of untreated patients with anterocollis and unilateral limb dystonia representing the most frequent forms. All were MSA-P cases. Discussing the pathophysiology of dystonia, they quoted previous neuropathological studies attributing anterocollis to neuronal loss in the ventral putamen.2 In five of their 24 patients, four of whom were listed as levodopa responsive MSA-P, neuropathology confirmed the diagnosis of MSA, but the degree of degeneration varied considerably. As the neuropathology findings could not be included into this paper, these and other morphological data will be briefly discussed. In case 14 …