MULTIPLE SYSTEM ATROPHY - CLINICAL AND MR OBSERVATIONS ON 42 CASES

Probable or possible multiple system atrophy (MSA) was diagnosed on st rict clinical criteria in 42 patients: 20 with combined parkinsonism a nd cerebellar ataxia, 9 with striatonigral degeneration (SND) and 13 w ith olivopontocerebellar atrophy (OPCA). All patients were then studie d with 0.5 and/or 1.5 Tesla magnetic resonance (MR) units. MR imaged p utaminal abnormalities in all 9 patients with SND and posterior fossa abnormalities consistent with OPCA in all 13 patients with this diagno sis. Of the 20 patients with parkinsonism and cerebellar involvement, classified as probable MSA, 7 presented putaminal abnormalities only, 3 abnormalities consistent with OPCA only and 10 a combination of both . These findings show strong MRI support for the clinical diagnosis of MSA.