Multiple system atrophy-parkinsonism with slow progression and prolonged survival: A diagnostic catch
Movement Disorders, 08/03/2012

Petrovic IN et al. – Late appearance of dysautonomia is a favorable prognostic factor in Multiple system atrophy (MSA)–P. Greater awareness of this uncommon “benign” subgroup of MSA will improve diagnostic accuracy and help to more accurately inform treatment options.

• The clinical and neuropathological features of 4 MSA cases with disease duration of 15 years or more were analyzed.

• All patients presented with parkinsonism and had a mean latency of 11 years before the development of dysautonomia.
• Mean duration from onset of first symptoms to anterocollis, inspiratory stridor, and dysphagia was 9 years.
• Despite the limited levodopa response, all patients developed levodopa–induced dyskinesia.