duo xi tong wei suo huan zhe de lin chuang te dian fen xi

Objective To investigate subtypes and clinical features of multiple system atrophy(MSA).Methods The clinical data of 105 probable MSA patients treated in our hospital from January 2009 to January 2011 were analyzed,including the age at onset,initial symptoms,clinical manifestations and responsivity to levodopa.Results The 105 probable MSA patients consisted of 57 males and 48 females,including 76 patients(72.4%) of MSA with predominant cerebellar ataxia(MSA-C) and 29 patients(27.6%) of MSA with predominant parkinsonism(MSA-P).The mean age at onset was 58 years.The initial symptom of 39 patients was pure cerebellar dysfunction.Twenty-nine patients presented pure parkinsonism as the initial symptom.The initial symptom of 23 patients was pure dysautonomia.By the last clinical visit,54 patients had cerebellar dysfunction,parkinsonism,autonomic failure and pyramidal signs.Conclusion The study revealed a predominance of MSA-C patients.The differentiation of MSA and other forms of parkinsonism or cerebellar ataxia may be difficult at the early stage.For more accurate diagnosis,it is important to carefully observe the clinical progression.