Multiple system atrophy in a man misdiagnosed with parkinsonism

Multiple system atrophy (MSA) is a rare sporadic, progressive, neurodegenerative disorder with autonomic deficits, with a yearly incidence of 0.000006%. MSA is often misdiagnosed as idiopathic Parkinson’s Disease (PD). It may present with a combination of parkinsonian, autonomic, and cerebellar signs. From a prognostic point of view, accurate diagnosis is essential. Our patient was misdiagnosed as having PD, but after thorough workup was diagnosed as having MSA type Parkinson’s. Because of this, the patient was put on supportive treatment for MSA. The authors strive to differentiate between the types of multiple system atrophy and its diagnostic criteria as well as differences between MSA and Parkinson’s.