Multiple system atrophy and autonomic failure C J Mathias

Neurovascular Medicine Unit, Faculty of Medicine, Imperial College London at St. Mary's Hospital & Autonomic Unit, National Hospital for Neurology & Neurosurgery, Queen Square & Institute of Neurology, University College London, London, UK

Summary. Multiple system atrophy (MSA) is a sporadic neurodegenerative disorder that affects adults. It is characterised by autonomic failure affecting many systems; cardiovascular, urinary, sexual, gastrointestinal and sudomotor, amongst others. In addition there are motor deficits, resulting in both parkin-sonian and/or cerebellar features. This review will outline the clinical features, investigations and management of MSA, with a particular emphasis on autonomic failure.

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