Walsh & Hoyt: Multiple System Atrophy

The term multiple system atrophy (MSA) was introduced by Graham and Oppenheimer to describe a neurologic condition previously described as Shy-Drager syndrome (SDS), olivopontocerebellar atrophy (OPCA), or striatonigral degeneration (SND), depending on the clinical predominance of autonomic failure, cerebellar signs, or parkinsonism. Although some authors suggest that MSA can be used interchangeably with the generic term multiple system degeneration, it is more appropriate in our opinion to reserve MSA for cases of SDS, SND, and sporadic OPCA and not to include inherited OPCA or other multiple system degenerative conditions, such as Huntingtons disease (HD) and PSP.