Multiple system atrophy with oculomotor abnormalities as a prominent manifestation: A case series

作者：Wei, Yuanxiao; Chen, Ju; Lu, Cancan; Jiang, Yijing; Liu, Zhiqiang; Zhang, Wenzhao; Fang, Liqun^*

来源：Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries, 2023, 102(25): e34008.

DOI：10.1097/MD.0000000000034008

• multiple system atrophy
• oculomotor abnormality
• vertigo

Rationale: Multiple system atrophy (MSA) is a group of adult-onset sporadic neurodegenerative diseases, mainly classified as MSA-C and MSA-P types. Due to the diversity of clinical symptoms, diagnosis faces a significant challenge. In the present case, we report a patient with isolated vertigo as the first presentation and abnormalities of the oculomotor system as the characteristic manifestations. @@@ Case concern: A 64-year-old male had dizziness for 1 year, aggravated for 4 months, with accompanying symptoms of unsteady walking. Physical examination revealed spontaneous nystagmus, abnormal ataxic movements, and a broad basal gait. Video nystagmography revealed saccade intrusions and macrosaccadic oscillations, and opsoclonus. Magnetic resonance imaging (MRI) was unremarkable early, and positron emission tomography-computed tomography (PET-CT) announced a reduction in the volume of the cerebellum and brainstem. @@@ Diagnosis: The diagnosis of the possibility of MSA type-C, peripheral neuropathy, hypertension, and lacunar cerebral infarction was performed. @@@ Conclusion: Atypical early clinical presentation may lead to delays, and identifying the critical problem through the patient simple clinical status requires long-term clinical experience and various ancillary examination tools.

• 单位
  哈尔滨医科大学