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Introduction
- Sporadic progressive neurodegenerative disorder
- Adulthood onset
- Glial cytoplasmic inclusions containing alpha synuclein
- Combination of cerebellar, autonomic, extra-pyramidal and pyramidal signs
- MSA-P: predominant parkinsonian features
- MSA-C: predominant cerebellar dysfunction
Imaging
- MSA-C: reduced pontine volume. Cerebellar atrophy. Cruciform T2 pontine hyperintensity (hot cross bun sign)
- MSA-P: also shows excess mineralization of bilateral putamina and substantia nigra
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