A critique of the second consensus criteria for multiple system atrophy

Abstract

Multiple system atrophy (MSA) is an adult-onset progressive neurodegenerative disorder that manifests clinically with autonomic failure, parkinsonism, and ataxia in any combination. Oligodendroglial cytoplasmatic inclusions consisting of misfoldedα-synuclein are a pathological hallmark of disease. The clinical diagnosisof MSA is typically delayed as a result of incomplete or nonspecific manifestations during early disease stages.