{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:37:08Z","timestamp":1761007028532,"version":"build-2065373602"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,11,4]],"date-time":"2004-11-04T00:00:00Z","timestamp":1099526400000},"content-version":"vor","delay-in-days":2864,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[1997,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Early diagnosis of multiple\u2010system atrophy (MSA) is important in patients presenting with late\u2010onset cerebellar ataxia because it has a less favourable prognosis than other degenerative ataxic disorders. We report cerebellar presentation of MSA in a series of 16 patients, 3 of whom later developed parkinsonism. Two\u2010thirds of them had early evidence of impaired postural reflexes with a history of recurrent falls. Some of these had a narrow\u2010based, unsteady gait, unlike the more classic broad\u2010based gait ataxia of cerebellar disease. On review of the patients' histories, genitourinary dysfunction (particularly impotence) was present at the onset of, or preceding, cerebellar ataxia in 60% of patients, but this had often been attributed to age, or to urological or gynaecological causes. External striated anal or urethral sphincter electromyography (EMG) demonstrated features of chronic denervation and reinnervation in 14 (93%) of 15 patients, consistent with degeneration in Onuf's nucleus as occurs in MSA. Autonomic function tests were abnormal in 9 (64%) of 14 patients. Our data suggest that close enquiry into genitourinary function and analysis of the gait disorder can be useful pointers to a diagnosis of MSA in patients with an unexplained adult\u2010onset progressive cerebellar syndrome, and that sphincter EMG is the most useful investigation in this context.<\/jats:p>","DOI":"10.1002\/mds.870120121","type":"journal-article","created":{"date-parts":[[2005,5,28]],"date-time":"2005-05-28T20:16:17Z","timestamp":1117311377000},"page":"115-117","source":"Crossref","is-referenced-by-count":31,"title":["Cerebellar presentation of multiple system atrophy"],"prefix":"10.1002","volume":"12","author":[{"given":"G. K.","family":"Wenning","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Kraft","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Beck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. J.","family":"Fowler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. J.","family":"Mathias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. P.","family":"Quinn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. E.","family":"Harding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,11,4]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.12.1239"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/117.4.835"},{"key":"e_1_2_1_4_2","first-page":"281","volume-title":"Autonomic failure: A textbook of clinical disorders of the autonomic nervous system","author":"Bannister R","year":"1981"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(81)90104-0"},{"key":"e_1_2_1_6_2","first-page":"262","volume-title":"Movement disorders 3","author":"Quinn N","year":"1994"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(82)90011-9"},{"key":"e_1_2_1_8_2","doi-asserted-by":"crossref","unstructured":"PappMI KahnJE LantosPL. Glial cytoplasmic inclusions in the CNS of patients with multiple system atrophy (striatonigral degeneration olivopontocerebellar atrophy and Shy Drager syndrome).J Neurol Sci1989:79\u2013100.","DOI":"10.1016\/0022-510X(89)90219-0"},{"key":"e_1_2_1_9_2","unstructured":"LantosPL PappMI. Cellular pathology of multiple system atrophy: a review.J Neurol Neurosurg Psychiatry1994;1\u20135."},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.9.1047"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1989.tb06043.x"},{"key":"e_1_2_1_12_2","first-page":"255","volume-title":"Autonomic failure: A textbook of clinical disorders of the autonomic nervous system","author":"Mathias CJ","year":"1992"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.48.10.1004"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)35246-1"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmds.870120121","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.870120121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:09:38Z","timestamp":1760958578000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.870120121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1997,1]]}},"alternative-id":["10.1002\/mds.870120121"],"URL":"https:\/\/doi.org\/10.1002\/mds.870120121","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"type":"print","value":"0885-3185"},{"type":"electronic","value":"1531-8257"}],"subject":[],"published":{"date-parts":[[1997,1]]}}}