CLINICAL CASE OF MULTISYSTEM ATROPHY WITH PARKINSONISM

Multiple system atrophy (MSA) is a steadily progressive neurodegenerative disease involving the pyramidal system, cerebellum, and autonomic nervous systemх[1]. MSA is an α-synucleinopathy with specific glioneuronal degeneration involving striatonigral, olivopontocerebellar, and autonomic nervous systems but also other parts of the central and peripheral nervous systems[3]. Clinical manifestations include hypotension, urinary retention, constipation, ataxia, parkinsonism, and postural instability. Multiple system atrophy affects both men and women equally, the first symptoms usually appear after age 53. The etiology of this pathology is unknown, but is associated with the accumulation of bodies containing alpha-synuclein in different parts of the brain[1]. There are two types of MSA. The first type occurs with a predominance of cerebellar dysfunctions: ataxia, postural instability. In the clinical setting of the second type of MSA, symptoms of parkinsonism predominate, such as muscle rigidity, bradykinesia, postural disturbances, non-resting tremor and dysarthria. Also, both types exhibit autonomic disorders. The prognosis for this pathology is unfavorable; after the first symptoms appear, life expectancy is 9-10 years.

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