Multi-system Atrophy (Shy-Drager)

Etiology

  • Rare neurodegenerative d/o
  • Progresses over 6-10 years

Risk Factors

  • Age 50-60

Symptoms

  • Variability in presentation
  • Initially autonomic dysfunction including orthostatic hypotension; if severe→ syncope/presyncope
  • Urge incontinence
  • Erectile dysfunction
  • Other sexual dysfunction
  • Then parkinsonian features of slow movements, falls, rigidity, often asymmetric tremor, dysphonia, dystonias
  • Cerebellar dysfunction w/ataxia and poor coordination
  • Depression and anxiety
  • Sob from stridor

Physical Exam Findings

  • Abnormal gait
  • Nystagumus
  • Orhtostatic VS, abnormal posture
  • Cerebellar dysfunction→ action tremor
  • Coordination problems
  • Ataxic/wide-based gait