Red flags for multiple system atrophy

  title={Red flags for multiple system atrophy},
  author={Martin K{\"o}llensperger and Felix Geser and Klaus Seppi and Michaela Stampfer-Kountchev and Martin Sawires and Christoph Scherfler and Sylvia Boesch and Joerg Mueller and Vasiliki Koukouni and Niall P. Quinn and Maria Teresa Pellecchia and Paolo Barone and N. Schimke and Richard Dodel and Wolfgang Hermann Oertel and E. Dupont and Karen {\O}stergaard and Christine Daniels and G{\"u}nther Deuschl and Tanya Gurevich and Nir Giladi and Miguel Coelho and Cristina Sampaio and Christer Nilsson and H{\aa}kan Widner and Francesca del Sorbo and Alberto Albanese and Adriana Cardozo and Eduardo Tolosa and M. Abele and Thomas Klockgether and Christoph Kamm and Thomas Gasser and Ruth Djaldetti and Carlo Colosimo and Giuseppe Meco and Anette E Schrag and Werner Poewe and Gregor K. Wenning},
  journal={Movement Disorders},
The clinical diagnosis of multiple system atrophy (MSA) is fraught with difficulty and there are no pathognomonic features to discriminate the parkinsonian variant (MSA-P) from Parkinson's disease (PD. [] Key Method To study the diagnostic role of these features in MSA-P versus PD patients, a standardized red flag check list (RFCL) developed by the European MSA Study Group (EMSA-SG) was administered to 57 patients with probable MSA-P and 116 patients with probable PD diagnosed according to established…

Red flags to spot the parkinsonian variant of multiple system atrophy

A multicenter study performed by the European MSA Study Group that sought to determine whether certain clinical features could serve as 'red flags', or warning signs, to assist in the early diagnosis of MSA-P found that the identified red-flag categories may be useful as supportive criteria in diagnosing probable M SA-P.

A Review on the Clinical Diagnosis of Multiple System Atrophy.

The core and supportive clinical features for a diagnosis of MSA in light of the new MDS MSA criteria are discussed, which laboratory tools may assist in the clinical diagnosis and which major differential diagnostic challenges should be borne in mind.

Diagnosing multiple system atrophy at the prodromal stage

Building on similar approaches as for PD and DLB, features on history-taking, clinical examination, and ancillary clinical testing that can predict the likelihood of an individual developing MSA are identified, while also distinguishing it from PD andDLB.

Various Motor and Non-Motor Symptoms in Early Multiple System Atrophy

Evaluating the frequency of various motor and non-motor symptoms including so-called “red flags” in patients with early MSA found that the diagnostic accuracy can be improved if these features are appropriately reflected in the new diagnostic criteria for MSA.

Multiple system atrophy.

The historical milestones, etiopathogenesis, neuropathological findings, clinical features, red flags, differential diagnosis, diagnostic criteria, imaging and other biomarkers, current treatment, unmet needs and future treatments for MSA are discussed.

Diagnosis of multiple system atrophy

Axial motor clues to identify atypical parkinsonism: A multicentre European cohort study.

Eye signs in patients with parkinsonism: do they predict the development of multiple system atrophy?

  • W. Fletcher
  • Psychology, Medicine
    Nature Clinical Practice Neurology
  • 2008
Several issues to consider before adopting oculomotor signs as predictors of MSA are outlined, including the study's high proportion of patients with late-stage MSA, its use of data from previous studies without matching for patient or study variables, the confounding effect of combining data from parkinsonian and cerebellar variants of M SA, conflicting data reported in previous studies, and the effect of disease prevalence on the positive predictive value of such signs.

[Multiple system atrophy].

No specific therapy is available for cerebellar dysfunction, while effective treatments exist for urinary and cardiovascular autonomic failure, and physical therapy may help to improve the difficulties of gait and stance, and to prevent their complications.



What clinical features are most useful to distinguish definite multiple system atrophy from Parkinson's disease?

Predictive models may help differentiate MSA and PD premortem and poorly recognised features, suggestive of MSA, included preserved cognitive function and absence of psychiatric effects from antiparkinsonian medication.

Progression of parkinsonism in multiple system atrophy

This is the first observational study on UPDRS rates of decline in MSA and shows that motor progression appeared to be accelerated during the early disease stages, which is helpful for the planning of future therapeutic trials.

Do published criteria improve clinical diagnostic accuracy in multiple system atrophy?

This study shows a high diagnostic accuracy for the clinical diagnosis of MSA by neurologists, with PD accounting for most of the false positive diagnoses.

Multiple system atrophy: A review of 203 pathologically proven cases

Characteristic glial and/or neuronal cytoplasmic inclusions were identified in all cases in which they were sought, irrespective of clinical presentation, and an association of postural hypotension with intermediolateral cell column degeneration was confirmed.

Dystonia in multiple system atrophy

The prospective clinical study suggests that dystonia is common in untreated MSA-P, which may reflect younger age at disease onset and putaminal pathology in MSA, and future studies are required to elucidate the underlying pathophysiology of dystonian features.

Multiple system atrophy--the nature of the beast.

  • N. Quinn
  • Medicine
    Journal of neurology, neurosurgery, and psychiatry
  • 1989
The history and nosology of the condition are considered, and provisional diagnostic criteria are advanced and the usefulness (or otherwise) of ancillary investigations is addressed, and the shortcomings of current methods of treatment are stressed.

How to diagnose dementia with Lewy bodies: State of the art

Using operationalized criteria, DLB can be diagnosed clinically with an accuracy similar to that achieved for AD or PD, and future modifications of diagnostic criteria would ideally include the full range of clinical presentations that can be associated with LB disease.

How to diagnose multiple system atrophy

  • N. Quinn
  • Medicine, Psychology
    Movement disorders : official journal of the Movement Disorder Society
  • 2005
The diagnosis of multiple system atrophy (MSA) in life remains entirely clinical. Consensus diagnostic criteria have been developed, but their use does not particularly render a diagnosis of MSA more

Consensus statement on the diagnosis of multiple system atrophy

Progression and prognosis in multiple system atrophy: an analysis of 230 Japanese patients.

The interval from initial symptom to combined motor and autonomic dysfunction can predict functional deterioration and survival in MSA, and the relationship between atrophy and functional status was highly variable among the individuals, suggesting that other factors influenced the functional deterioration.