msa多系統(tǒng)萎縮(ppt45頁(yè))(完整版)
【正文】 cterized by neuronal degeneration mainly in the substantia nigra, striatum, autonomic nervous system, and cerebellum. Company Logo 一、病例介紹 (case description) ?李 XX，男， 47歲，國(guó)家公務(wù)員。 ? 雙手輪替笨拙，雙下肢跟膝試驗(yàn)不穩(wěn)； ? 右下肢病理征陽(yáng)性； ? 自行站立、行走困難；感覺(jué)正常，生活不能自理。 ?少突膠質(zhì)細(xì)胞包涵體在 MSA的不同亞型中均有發(fā)現(xiàn)，具有較強(qiáng)的特異性，它從病理學(xué)上證實(shí)了SND， OPCA及 SDS 是具有不同臨床表現(xiàn)的同一組疾病， 現(xiàn)已成為 MSA的一個(gè)病理學(xué)指標(biāo) 。 it may cause dysphonia or stridor and airway obstruction Company Logo Company Logo Motor disorder Parkinsonism ?bradykinesia with rigidity, tremor, or postural instability ? The tremor is usually irregular and postural/action, often incorporating myoclonus, but a classic pillrolling rest tremor is unmon. ? The parkinsonism can be asymmetric. ? Postural instability, occurs earlier and progresses more rapidly than in PD. ? Parkinsonism usually responds poorly to chronic levodopa therapy。 2023 Second consensus statement on the diagnosis of multiple system atrophy Company Logo 4 Clinical features Criteria for MSA Company Logo Criteria for possible MSA ?A sporadic,progressive,adult(30y)onset disease characterized by ?Parkinsonism or ?Cerebellar syndrome and ?At least one feature suggesting autonomic dysfunction and ?At least one of additional features additional features of possible MSA ?Possible MSAP or MSAC ?Babinski sign with hyperreflexia ?Stridor Possible MSAP ?Rapidly progressive parkinsonism ?Poor response to levodopa ?Postural instability within 3y of motor onset ?Gait ataxia,cerebellar dysa
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