Case 42: Multiple System Atrophy Versus Parkinson’s Disease?

Abstract

This patient showed evidence of mild but widespread autonomic dysfunction. These findings are nonspecific and can be seen in variety of central (α‎-synucleinopathies) and peripheral (autonomic neuropathy/ganglionopathy) disorders. Clinical workup for neuropathy showed elevated acetylcholine ganglionic neuronal antibodies. Immunotherapy with intravenous immunoglobulins for suspected autoimmune autonomic neuropathy was recommended.