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Postgraduate Medical Journal 2001;77:379-382; doi:10.1136/pmj.77.908.379
© 2001 BMJ Publishing Group Ltd and The Fellowship of Postgraduate Medicine.
Postgrad Med J 2001;77:379-382 ( June )

Review

Multiple system atrophy

H U Rehman

Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK

Correspondence to: Dr Rehman

Submitted 12 July 2000; Accepted 28 November 2000

The first 150 words of the full text of this article appear below.

    Introduction

Multiple system atrophy (MSA) is a degenerative disease of the central nervous system. Dejerine and Thomas in 1900 were the first to use the term olivopontocerebellar atrophy (OPCA) in two sporadic cases,1 although Menzel described the first case in 1891. Shy and Drager in 1960 described four cases of a "neurological syndrome with orthostatic hypotension".2 They defined the full syndrome comprising of orthostatic hypotension, urinary and rectal incontinence, loss of sweating, iris atrophy, external ocular palsies, rigidity, tremor, loss of associated movements, impotence, atonic bladder, loss of rectal sphincter tone, fasciculations, wasting of distal muscles, evidence of a neuropathic lesion in the electromyogram suggesting involvement of the anterior horn cells, and the finding of a neuropathic lesion in the muscle biopsy. Adams et al first described a syndrome designated striatonigral degeneration in the early 1960s.3 These patients had mild autonomic failure and ataxia and were shown to have lesions in the olivopontocerebellar system. . . . [Full text of this article]
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