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Multiple system atrophy (MSA-P)

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Recurrent falls on background of idiopathic Parkinson's disease.

Patient Data

Age: 65 years
Gender: Female

Reversal of the expected magnetic susceptibility pattern within the basal ganglia with more prominent T2* hypointensity within the putamen than the globus pallidus. There is also subtle corresponding decreased T2 signal within the putamen relative to the globus pallidus, and a linear rim of high T2 / FLAIR signal. 

Case Discussion

Findings and clinical setting are consistent with multiple system atrophy with predominant Parkinsonian signs and symptoms (MSA-P).  

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