Guest guest Posted August 10, 2001 Report Share Posted August 10, 2001 Pam, thank goodness you threw in that last paragraph! I was beginning to get confused -- again. Seriously, a very helpful response as usual. To my knowledge Larry has never been given any Levadopa therapy -- probably because his symptoms at onset were more cerebellar (ataxia, speech, balance) and I've never heard him remark at all about the typical PD things such as tremor or rigidity. As he has progressed, he now has the autonomic dysfunction, including urinary retention and OH. Jerry Diagnosing MSA Hi Jerry, There are some criteria that were agreed upon among by many MSA researchers a couple years ago in their " Consensus Statement on Multiple System Atrophy " . In order to diagnose MSA they look at groups of symptoms which include: Cerebellar signs - these are common in the OPCA subtype of MSA Autonomic dysfunction - these are common in the SDS subtype of MSA Parkinsonism - these are common in the SND subtype of MSA Based on which symptoms people displayed they concluded that they could have: 1. Possible MSA 2. Probable MSA or 3. Definite MSA - they can only know this after autopsy when glial cytoplasmic inclusions are observed in brain cells --- The below is quoted from this website: http://www.bcm.tmc.edu/neurol/challeng/pat22/summary.html " Definitive diagnosis of MSA requires autopsy, but clinical criteria for diagnosis of SND and OPCA subtypes have been developed. The diagnosis of possible MSA, SND subtype may be made in any patient with parkinsonism and a poor response to levodopa therapy. The diagnosis of probable MSA, SND subtype also includes evidence of autonomic dysfunction, cerebellar signs, pyramidal signs, dystonia, or abnormal responses to sphincter EMG. The diagnosis of possible MSA, OPCA subtype may be made in any patient with a sporadic, adult-onset cerebellar syndrome associated with parkinsonism. The diagnosis of probable MSA, OPCA subtype also includes evidence of pyramidal signs, autonomic failure, oculomotor disturbances and/or pathologic sphincter EMG. " --- So to answer your question, if someone with cerebellar signs later develops autonomic dysfunction along with cerebellar signs this would likely move them from the " Possible MSA, OPCA subtype category " to the " Probable MSA, OPCA subtype category " . Regards, Pam Jerry Cash wrote: > > Doug or others, > > To what extent, if any, does the onset of OH and/or autonomic dysfunction > move one toward confirming a diagnosis of MSA (or Shydrager) vs sporadic > OPCA? > > Jerry > If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 10, 2001 Report Share Posted August 10, 2001 Greetings Jerry! You noted: > ... I've never heard him remark at all about the > typical PD things such as tremor or rigidity. Actually, MSA patients tend to not show tremors ... though rigidity and stooped posture are very common. > As he has progressed, he now has the autonomic > dysfunction, including urinary retention and OH. Which of course moved him into the 25% of OPCA patients that develop into MSA. Regards, =jbf= B. Fisher Quote Link to comment Share on other sites More sharing options...
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