Multiple system atrophy - cerebellar type

Case contributed by Dr Prashant Gupta


Tremors, dysdidokokinesia, gait instability and dysarthria for two years. Clinically suspected parkinson variant.

Patient Data

Age: 50 years
Gender: Male

Significant cerebellar atrophy with the "hot cross bun" sign in the midbrain. Sagittal images demonstrating the the midbrain is not atrophic.

Case Discussion

This MRI suggests a possible multiple system atrophy of cerebellar type (MSA-C). Atypical parkinsons syndromes are important to detect on imaging as they are unresponsive to levodopa.

MSA presents as a variable combination of parkinsonism, cerebellar ataxia and/or autonomic failure such as orthostatic hypotension. Striatonigral degeneration (SND) is now known as MSA-P, olivopontocerebellar atrophy (OPCA) is now known as MSA-C. Both MSA-P and MSA-C may have variable components of SDS.

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Case information

rID: 18499
Published: 10th Jul 2012
Last edited: 15th Sep 2018
Tag: msa-c
Inclusion in quiz mode: Included

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