Abstract

Multiple system atrophy (MSA) is a progressive degenerative disorder in which damage to brain cells leads to varying degrees of parkinsonism, autonomic failure and ataxia (poor damage and co-ordination). Any combination of two or more of these is indicative of MSA. The condition was initially considered to be a Parkinson's Plus syndrome. Indeed, in the early stages it is impossible to distinguish MSA from Parkinson's disease although the 'pill-rolling' rest tremor is rarely seen.

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