neurologic disorders
Multiple System Atrophy (MSA)
Diagnosis of Multiple System Atrophy
Clinical evaluation (autonomic insufficiency plus parkinsonism or cerebellar symptoms that respond poorly tolevodopa) MRI Autonomic tests Diagnosis of multiple system atrophy is suspected clinically, based on the combination of autonomic insufficiency and parkinsonism or cerebellar symptoms. Similar symptoms may result from Parkinson Disease , No diagnostic test is definitive, but some (eg, MRI, nuclear imaging with123I-metaiodobenzylguanidine [MIBG], autonomic tests) help confirm clinical suspicion of multiple system atrophy—for example, if MRI shows characteristic changes in the midbrain, pons, or cerebellum. MIBG scans show intact innervation of the heart (because the lesion is preganglionic in multiple system atrophy) Autonomic tests indicate generalized autonomic failure. 