Multiple system atrophy

Discussion:

In this case, signs and symptoms of both striatonigral degeneration and olivopontocerebellar atrophy were present. The I-123 Ioflupane scan showed grossly abnormal radiotracer uptake which is a non-specific finding and can be seen in Parkinson disease and well as in a range of "Parkinson-plus" syndromes. Similarly, the hot cross bun sign is non-specific and can be seen in a number of neurodegenerative diseases including vCJD.

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