Abstract
Multiple system atrophy (MSA) is a neuro-degenerative disease, pathologically characterized by α-synuclein (αSyn)-immunopositive glial cytoplasmic inclusions (GCI). Compar ing to other synucleinopathies such as Parkinson's disease (PD) or Dementia with Lewy body (DLB), MSA has not been characterized by dementia. However, recent studies reported that various types of cognitive impairments could be presented in MSA.1 We report a case of MSA with severe cognitive impairment that proceeded 6 years before cerebellar dysfunctions of MSA.
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