Palabras clave: atrofia de múltiples sistemas (AMS), disautonomía, ataxia cerebelosa, el síndrome de Shy- Drager, la degeneración nigroestriada. (SND) y la. Shy-Drager syndrome a case report with polysomnography. Síndrome de Shy- Drager: registro de caso com estudo polissonográfico. F. S. Aloe; P.E. Marchiori; . A atrofia de múltiplos sistemas (AMS) é uma doença neurodegenerativa esporádica nigro-estriatal, atrofia olivopontocerebelar, síndrome de Shy- Drager.

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What is accuracy of the clinical diagnosis of multiple system atrophy? Speech therapy will be recommended for the patient to deal with dysphagia. Oliver JA, Oddershede IR, Ebert MH – Urynary catecholamine metabolites distinguish different types of sympathetic neuronal dysfunction patients with orthostatic hypotension.

Multiple system atrophy MSA is a dragfr, neurodegenerative disorder, characterized by several combinations of parkinsonian, autonomic, cerebellar and pyramidal signs Characteristcs of the dysarthria of multiple system atrophy.

Ann Cardiol Angiol If Shy-Drager Syndrome is suspected in an individual, then the doctor will take a detailed history of the patient inquiring as to when the symptoms started and how much severe the symptoms are.

Shy-Drager syndrome a case report with polysomnography

Shy-Drager Syndrome which is also referred to as Multiple System Atrophy is an extremely rare neurological condition in which the autonomic functions of the body get impaired. In the later stages of the disease, as a result of autonomic dysfunction, some patients develop breathing problems including loud respiration and cessation of breathing during sleep. Eighteen months after he noted gait and speech alteration. Muscle strength and coordination can be managed by a physical therapist.

New Engl J Med Estudo de dois casos. In the first case, the disease started when the patient was 53 years old with autonomic dysfunction and progressed with cerebellar signs within one year and six months after onset.


The hands and feet will be cold. They concluded that instability due to previous falls, lack of tremor, fast progression of the disease and poor response to levodopa xe be the firsts symptoms of MSA. After six months he presented nystagmus and many episodes of syncope.

A physical examination will also be performed to check for any muscle stiffness.

Treatment with midodrine started. We mainly draw attention to the importance of a good neuroradiological assessment. What causes Shy-Drager Syndrome is not known as of yet. Autonomic failure was made evident by physical examiration as well as laboratory tests. Some patients with SDS complain of difficulties with focusing and other visual symptoms. Longitudinal MRI study of multiple system atrophy: Not all specialists use the term “Shy-Drager” to mean precisely the same condition, and diagnostic certainty cannot at present be achieved during life.

AP laying down was X90 and seated was 90X 50mmHg. There was no rest or postural tremor, but the speech was slurred, very difficult to be understood. There is some doubt if the term Shy-Drager syndrome should be substitute, as most cases of MSA patients develop autonomic dysfunction during their course 6.

Slurred ve was the patients main complain, limiting his daily activity. This same study reported that in patients with MSA-P hypokinetic dysarthria predominates as much as the hypomimic facial features, and lips or tongue tremor.

It is hard to establish the differential diagnosis with Parkinson’s disease, as it can be seen in isndrome case. Some studies suggest that may be responsible for development of Shy-Drager Syndrome. Shy-Drager usually ends in death 7 to 10 years after the onset of symptoms. Sometimes it presents with low blood pressure on standing, urinary bladder problems, or difficulties with balance and movement that resemble Parkinson’s disease.

Lippincott Willians and Wilkins, There is no cure for MSA, and there is no known means to slow progression. MRI of the brain showed the pontine “cross sign”, one more feature of this type of disease Fig 1A. The autonomic nervous system is also responsible for constriction and dilation sindroe pupils. We describe two patients showing different presentations of the same disease.


Schatz IJ – Orthostatic hypotension: Arterial pressure AP was X80 mmHg and radial pulse frequency 60 bpm with the patient laying down; X70 and 70bpm when standing up. Drqger upon which part of the brain is affected first, MSA may appear in different ways.

A sleep recording showed decreased percentage of REM sleep and apneas of the central type.

Shy-Drager Syndrome: Causes, Symptoms, Treatment, Prognosis, Life Expectancy

Our patient number 2 presented insomnia. Medications may be prescribed for blood pressure control. Dietary increases of salt and fluid may be helpful. In the last 6 months, he became aid-requiring walking and presented intestinal constipation. Services on Demand Journal.

Shy Drager syndrome. – PubMed – NCBI

Sindro,e functions include the autonomic or involuntary nervous system which controls blood pressure, heart rate, and bladder function and the motor system which controls balance and muscle movement. Absence of alpha-synuclein mRNA expression in normal and multiple system atrophy oligodendroglia. Symptoms, Causes, Types, Treatment.

Both of them appears lately in MSA-A. Shy-Drager Syndrome has primarily two types of symptoms of which one is parkinsonian type symptoms and the other is cerebellar type symptoms. Constipation may improve with increased rrager fibre or laxatives. Subscribe to Free ePainAssist Newsletters.

Early symptoms often include impotence and urinary incontinence.