- Rare neurodegenerative d/o
- Progresses over 6-10 years
- 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
- Orhtostatic VS, abnormal posture
- Cerebellar dysfunction→ action tremor
- Coordination problems
- Ataxic/wide-based gait