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Washington University Experience | NEURODEGENERATION | Multiple Systems Atrophy (MSA) | 3A0 Case 3 History
Case 3 History ---- This 58yo male patient was first evaluated at the MDC in June 2008 with onset of slowness, micrographia, stooped posture, and shortened stride in 2003. He had worsening of his left upper extremity, slowness, and imbalance over the following 3 years. He had no memory complaints or falling. He had no pesticide, heavy metal, or neuroleptic exposure. He had mild orthostasis without syncope. On examination he had asymmetric bradykinesia and rigidity and mild postural instability. There was no evidence of cognitive impairment, dystonia, eye movement abnormality, or psychosis. He had a history of a clear and sustained response to levodopa, with motor fluctuations characterized by wearing off. On the UPDRS Subscale III (motor examination) he scored 39 out of 108. His clinical diagnosis was ‘probable’ idiopathic Parkinson’s disease. He was a patient in the MDC for 6 months, participated in the Mondriaan Study and received the study drug from 10/2008 until his death. The cause of death was pulmonary embolism and renal failure.
