{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:34:38Z","timestamp":1766399678499,"version":"3.48.0"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Multiple system atrophy (MSA) is a progressive adult\u2010onset neurodegenerative disorder that manifests as a variable combination of cerebellar, parkinsonian, and autonomic dysfunctions. We report a case of a 52\u2010year\u2010old woman who presented with rapidly progressive gait ataxia, dysarthria, orthostatic hypotension, and urinary urgency. MRI of the brain demonstrated pontocerebellar atrophy with the characteristic \u201chot cross bun\u201d sign, supporting a diagnosis of Multiple System Atrophy\u2013cerebellar type (MSA\u2010C). Despite receiving levodopa and supportive therapy, the symptoms progressed over 8\u2009months, highlighting the unusually rapid disease course. This case highlights the diagnostic value of targeted clinical assessment and MRI when advanced confirmatory tests are inaccessible, underscoring the importance of early recognition and multidisciplinary symptom management in resource\u2010constrained settings.<\/jats:p>","DOI":"10.1002\/ccr3.71529","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:08:42Z","timestamp":1764047322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rapidly Progressive Multiple System Atrophy\u2014Cerebellar Type in a 52\u2010Year\u2010Old Woman: Diagnostic Challenges in a Resource\u2010Limited Setting"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3169-1655","authenticated-orcid":false,"given":"Khushi V.","family":"Singh","sequence":"first","affiliation":[{"name":"Gujarat Medical Education and Research Society  Vadnagar India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2551-4983","authenticated-orcid":false,"given":"Sai Priya","family":"Nimmagadda","sequence":"additional","affiliation":[{"name":"Gandhi Medical College  Secunderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3921-4206","authenticated-orcid":false,"given":"Ameesh","family":"Panda","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College  Pune India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3302-3359","authenticated-orcid":false,"given":"Rarigela","family":"Rohith","sequence":"additional","affiliation":[{"name":"Gandhi Medical College  Secunderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6846-0423","authenticated-orcid":false,"given":"Tirth J.","family":"Patel","sequence":"additional","affiliation":[{"name":"Gujarat Medical Education and Research Society  Vadnagar India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8631-2802","authenticated-orcid":false,"given":"Sonika","family":"Gopathoti","sequence":"additional","affiliation":[{"name":"Siddhartha Medical College  Vijayawada India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6124-8058","authenticated-orcid":false,"given":"Prajesh V.","family":"Patel","sequence":"additional","affiliation":[{"name":"Gujarat Medical Education and Research Society  Vadnagar India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5110-1544","authenticated-orcid":false,"given":"Mihirkumar P.","family":"Parmar","sequence":"additional","affiliation":[{"name":"Gujarat Medical Education and Research Society  Vadnagar India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1042-5390","authenticated-orcid":false,"given":"Saleh","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Faridpur Medical College Hospital  Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010022\u201000382\u20106"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26052"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401\u2010010\u20100672\u20103"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022\u2010510x(89)90219\u20100"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/117.2.235"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21385"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000310413.04462.6a"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010045100"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468\u20101331.2002.00348.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910\u2010014\u20100493\u20101"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12145"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.suppl.78"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0304\u20103940(98)00504\u20107"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2005.073528"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2011.08.003"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M111.318949"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3406"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1113260108"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2013.09.004"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004010051177"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI43366"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20112457"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0903691106"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.02.010"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:31:02Z","timestamp":1766399462000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":24,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/ccr3.71529"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71529","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"assertion":[{"value":"2025-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71529"}}