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Table 1 Diagnosis of MSA-C, modified from Gilman et al., 2008 [ [27] ]

From: An update on the cerebellar subtype of multiple system atrophy

Probable MSA-C:

Possible MSA-C:

A sporadic progressive, adult (>30y)- onset disease characterized by:

A sporadic progressive, adult (>30y)- onset disease characterized by:

 • Autonomic failure involving urinary incontinence (inability to control the release of the urine from the bladder, with erectile dysfunction in males) or an orthostatic decrease of blood pressure with 3 min of standing by at least 30 mmHg systolic or 15 mmHg diastolic

 • Cerebellar syndrome

 • At least one feature suggesting autonomic dysfunction (otherwise unexplained urinary urgency, frequency, incomplete bladder emptying, erectile dysfunction, in males, or significant orthostatic blood pressure decline that does not meet the level required in probable MSA-C)

 • Cerebellar syndrome

 • At least one of the following feature:

    Babinski sing with hyperreflexia

    Stridor

    Parkinsonism (bradykinesia and rigidity)

    Atrophy on MRI of putamen, middle cerebellar peduncle, or pons

    Hypomethabolism on FDG-PET in putamen

    Presynaptic nigrostriatal dopaminergic denervation on PET or SPECT