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In June 2004, a 52-year-old woman was admitted to our department with a walking impairment and scanning speech that had persisted over the previous few months. A neurological examination revealed exclusively cerebellar signs with gait ataxia, slight oculomotor dysfunction and impaired coordination. Known medical and family history were unremarkable up to this point (however, no information could be provided on the patient's father). MRI scans showed a severe cerebellar atrophy of both hemispheres without any additional pathologies. Electrophysiological (evoked potentials) and blood examination, including vitamin E, vitamin B12, antineuronal antibodies and genetic testing for spinocerebellar ataxia genotypes 1, 2, 3 and 6, were negative for pathological findings. Over the following months the patient developed neurogenic bladder dysfunction with urge incontinence and incomplete bladder release, thus fulfilling the consensus criteria for probable multiple system atrophy of the cerebellar type (MSA-C).1 …
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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