CLINICAL CASE OF MULTISYSTEM ATROPHY WITH PARKINSONISM

Аннотация

INTRODUCTION maintain the quality of life of a patient with MSA at At the moment, diagnosis and treatment are an optimal level, prevent complications and limited. The diagnosis of multiple system atrophy increase the life expectancy of patients. is made on the basis of clinical data from a combination of signs of autonomic failure and Purpose of the study. To describe a clinical case of parkinsonism or cerebellar disorders, as well as Multiple System Atrophy with a predominance of MRI data. There is no specific treatment for MSA; parkinsonian symptoms in old age. only supportive therapy is provided [1]. The use of RESEARCH OBJECTIVES a combination of antiparkinsonian drugs- levadopa and carbidopa, may be ineffective or provide only 1. Analyze the theoretical concepts of Multiple minor benefit. None of the available treatments System Atrophy significantly slows the aggressive course of MSA[2]. 2. Carry out a theoretical analysis of symptoms, There is a need to consider new methods to methods of diagnosis and treatment of patients https://www.theamericanjournals.com/index.php/tajmspr 34 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE07 with MSA. arms and legs. Muscle strength is weakened. Static coordination tests are unsatisfactory. Romberg test Materials and methods. Patient G., 62 years old, is positive. Hyperkinetic syndrome - no. Scoliosis of was admitted with complaints of slow movements, the spinal column - no. Movement in the limbs is decreased strength in the arms and legs, a drop in limited. There are no meningeal symptoms. blood pressure, dizziness, instability when walking, and intermittent tremor in the arms. The Bradykinesia, muscle rigidity, increasing after above symptoms have been bothering him for 2 functional tests. During the examination, Levadopa years. Life history: without any developmental 125 mg was given. Functional tests were features. performed 45 minutes after taking the tablet. Based on complaints, medical history, and initial During the examination, neurological examination: examination, a preliminary diagnosis was made: the patient is conscious, oriented in time and place. Parkinson's disease. Multiple system atrophy Blood pressure = 90/60 mm Hg. The sensitive area (questionable). At the outpatient stage, an MRI of is unchanged. Eye movement is complete. There the brain was prescribed. are no vertical seconds. The pupils are the same D=S. Nystagmus is absent. There are no face zone RESULTS triggers. The face is symmetrical. There is no The patient's condition did not improve while smoothness of the nasolabial triangle. The tongue taking Levadopa 125 mg, blood pressure = 80/40 occupies a central position, the uvula in the center. mmHg, and when performing functional tests, There are no swallowing disorders. The pharyngeal rigidity in the limbs did not decrease. reflex is evoked. Hearing is not impaired. Muscle tone is reduced. Tendon reflexes: evoked from the https://www.theamericanjournals.com/index.php/tajmspr 35 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE07 differential diagnosis with the typical form of Based on the results of an MRI of the brain (3 Parkinson's disease, dementia with Lewy bodies, Tesla), the diagnosis was made: true autonomic failure, autonomic neuropathies, Multiple system atrophy; there are signs of atrophy progressive supranuclear palsy, multiple cerebral in the pons, midbrain and cerebellum in T1 mode. infarctions and drug-induced parkinsonism. Diagnostic criteria for making this diagnosis are: In the last few years, due to research and atrophic changes in the putamen, middle cerebellar technology development, a number of promising peduncles, pons and cerebellum. In addition, MSA imaging and laboratory markers have been is characterized by the “cross” sign, often described identified for the comprehensive diagnosis of MSA, in degenerative spinocerebellar ataxias, including at the initial stages of the hyperintensity of the dorsolateral edge of the neurodegenerative process. putamen in combination with hyperintensity of the