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Washington University Experience | NEURODEGENERATION | Multiple Systems Atrophy (MSA) | 11E2 MSA (Case 11) L17 pSYN 60X
The extent of involvement of pencil fibers by GCI is shown with pSYN immunoreactivity. (pSYN IHC) ---- Not shown: The electrode tract is outlined by a gliotic cavity. Numerous alpha synuclein-positive oligodendroglial inclusions (Papp-Lantos bodies) are present throughout the cerebral white matter and to a lesser extent in the deeper layers of the cerebral cortex. There are no diffuse beta-amyloid plaques, no neurofibrillary tangles, and no neuritic plaques. There is severe loss of neurons, gliosis and extracellular pigment in the substantia nigra. Numerous GCIs are present in the substantia nigra, red nucleus, crus cerebri and elsewhere in the midbrain. Lewy bodies and Lewy neurites were not present anywhere in the neuraxis so Parkinson's disease is excluded. No tau-positive pre-tangles or Lewy bodies are seen. In the cerebellum, there is white matter pallor, axon loss, gliosis, and multiple GCI, mainly in the white matter. The spinal cord is not available. ---- Neuro Final Diagnosis: Multiple system atrophy (Gilman et al. PMID: 10223419, MSA-P.); Organizing deep brain stimulation electrodes terminated in the subthalamic nuclei.
