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Clinical features that were analyzed included the rapidity of disease progression,the relative symmetry of symptom onset,the presence or absence of tremor at initial presentation,the therapeutic response to levodopa and the associated presence of autonomic dysfunction.Fourteen of the 16 patients also had a computed tomographic scan of the brain performed.The frequency of selected items in MSA was compared with that found in 20 pathologically confirmed cases of parkinson's disease and 16 pathologically confirmed cases of progressive supranuclear palsy(Steele- Richardson-Olszewski disease).It was found that a probability scale based on five selected items discriminated MSA with a pure parkinsonian presentation from Parkinson's disease,but not from progressive supranuclear palsy.Patients affected by the latter disorder,however, commonly presented with additional clinical features(supranuclear vertical downgaze palsy,axial dystonia,and cognitive impairment),which helped to differentiate it from MSA. |
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