{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:23:37Z","timestamp":1761895417758},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2011,12,1]],"date-time":"2011-12-01T00:00:00Z","timestamp":1322697600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Multiple system atrophy is a late, adult-onset \u03b1-synucleinopathy with no data on the effect of pregnancy on the disease course. Early stage multiple system atrophy can be difficult to distinguish from Parkinson's disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>We describe the case of an Irish woman with parkinsonism starting at age 31, initially diagnosed as having dopa-responsive, idiopathic Parkinson's disease, who successfully delivered a full-term child at age 35. Her pregnancy was complicated by severe orthostatic hypotension and motor fluctuations. Two years post-partum, she underwent bilateral subthalamic nuclei deep brain stimulation for intractable motor fluctuations and disabling dyskinesia. After this treatment course she experienced deterioration of motor symptoms and death eight years after disease onset. Post-mortem neuropathological examination revealed striatonigral degeneration and \u03b1-synuclein-positive glial cytoplasmic inclusions in brain stem nuclei, basal ganglia and white matter tracts, consistent with a neuropathological diagnosis of multiple system atrophy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Multiple system atrophy can affect women of child-bearing age and pregnancy may be associated with marked disease progression.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1752-1947-5-599","type":"journal-article","created":{"date-parts":[[2011,12,30]],"date-time":"2011-12-30T19:36:44Z","timestamp":1325273804000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pregnancy in multiple system atrophy: a case report"],"prefix":"10.1186","volume":"5","author":[{"given":"Lirong","family":"Zhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel J","family":"Cairns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samer D","family":"Tabbal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad A","family":"Racette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2011,12,30]]},"reference":[{"key":"1945_CR1","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1016\/S1474-4422(09)70288-1","volume":"8","author":"N Stefanova","year":"2009","unstructured":"Stefanova N, Bucke P, Duerr S, Wenning GK: Multiple system atrophy: an update. Lancet Neurol. 2009, 8: 1172-1178. 10.1016\/S1474-4422(09)70288-1.","journal-title":"Lancet Neurol"},{"key":"1945_CR2","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1212\/01.wnl.0000324625.00404.15","volume":"71","author":"S Gilman","year":"2008","unstructured":"Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ, Wood NW, Colosimo C, D\u00fcrr A, Fowler CJ, Kaufmann H, Klockgether T, Lees A, Poewe W, Quinn N, Revesz T, Robertson D, Sandroni P, Seppi K, Vidailhet M: Second consensus statement on the diagnosis of multiple system atrophy. Neurology. 2008, 71: 670-676. 10.1212\/01.wnl.0000324625.00404.15.","journal-title":"Neurology"},{"key":"1945_CR3","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1007\/s00702-005-0328-y","volume":"112","author":"F Geser","year":"2005","unstructured":"Geser F, Seppi K, Stampfer-Kountchev M, K\u00f6llensperger M, Diem A, Ndayisaba JP, Ostergaard K, Dupont E, Cardozo A, Tolosa E, Abele M, Dodel R, Klockgether T, Ghorayeb I, Yekhlef F, Tison F, Daniels C, Kopper F, Deuschl G, Coelho M, Ferreira J, Rosa MM, Sampaio C, Bozi M, Schrag A, Hooker J, Kim H, Scaravilli T, Mathias CJ, Fowler C: The European Multiple System Atrophy-Study Group (EMSA-SG). J Neural Transm. 2005, 112: 1677-1686. 10.1007\/s00702-005-0328-y.","journal-title":"J Neural Transm"},{"key":"1945_CR4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/S1474-4422(03)00662-8","volume":"3","author":"GK Wenning","year":"2004","unstructured":"Wenning GK, Colosimo C, Geser F, Poewe W: Multiple system atrophy. Lancet Neurol. 2004, 3: 93-103. 10.1016\/S1474-4422(03)00662-8.","journal-title":"Lancet Neurol"},{"key":"1945_CR5","doi-asserted-by":"publisher","first-page":"2604","DOI":"10.1002\/mds.23192","volume":"25","author":"M K\u00f6llensperger","year":"2010","unstructured":"K\u00f6llensperger M, Geser F, Ndayisaba JP, Boesch S, Seppi K, Ostergaard K, Dupont E, Cardozo A, Tolosa E, Abele M, Klockgether T, Yekhlef F, Tison F, Daniels C, Deuschl G, Coelho M, Sampaio C, Bozi M, Quinn N, Schrag A, Mathias CJ, Fowler C, Nilsson CF, Widner H, Schimke N, Oertel W, Del Sorbo F, Albanese A, Pellecchia MT, Barone P: Presentation, diagnosis, and management of multiple system atrophy in Europe: final analysis of the European multiple system atrophy registry. Mov Disord. 2010, 25: 2604-2612. 10.1002\/mds.23192.","journal-title":"Mov Disord"},{"key":"1945_CR6","first-page":"153","volume-title":"Recent Developments in Parkinson's Disease","author":"S Fahn","year":"1987","unstructured":"Fahn S, Elton R, UPDRS program members: Unified Parkinson's Disease Rating Scale. Recent Developments in Parkinson's Disease. Edited by: Fahn S, Marsden CD, Goldstein M, Calne DB. 1987, Florham Park, NJ: Macmillan Healthcare Information, 2: 153-163."},{"key":"1945_CR7","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1002\/1531-8257(199901)14:1<194::AID-MDS1044>3.0.CO;2-S","volume":"14","author":"J Benito-Leon","year":"1999","unstructured":"Benito-Leon J, Bermejo F, Porta-Etessam J: Pregnancy in Parkinson's disease: a review of the literature and a case report. Mov Disord. 1999, 14: 194","journal-title":"Mov Disord"},{"key":"1945_CR8","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1002\/mds.870130110","volume":"13","author":"P Hagell","year":"1998","unstructured":"Hagell P, Odin P, Vinge E: Pregnancy in Parkinson's disease: a review of the literature and a case report. Mov Disord. 1998, 13: 34-38. 10.1002\/mds.870130110.","journal-title":"Mov Disord"},{"key":"1945_CR9","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/S0022-510X(98)00304-9","volume":"163","author":"S Gilman","year":"1999","unstructured":"Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ, Kaufmann H, Klockgether T, Lang AE, Lantos PL, Litvan I, Mathias CJ, Oliver E, Robertson D, Schatz I, Wenning GK: Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci. 1999, 163: 94-98. 10.1016\/S0022-510X(98)00304-9.","journal-title":"J Neurol Sci"},{"key":"1945_CR10","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1002\/mds.23071","volume":"25","author":"SM Kranick","year":"2010","unstructured":"Kranick SM, Mowry EM, Colcher A, Horn S, Golbe LI: Movement disorders and pregnancy: a review of the literature. Mov Disord. 2010, 25: 665-671. 10.1002\/mds.23071.","journal-title":"Mov Disord"},{"key":"1945_CR11","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1212\/WNL.32.5.547","volume":"32","author":"WC Koller","year":"1982","unstructured":"Koller WC, Barr A, Biary N: Estrogen treatment of dyskinetic disorders. Neurology. 1982, 32: 547-549.","journal-title":"Neurology"},{"key":"1945_CR12","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1212\/WNL.52.7.1417","volume":"52","author":"R Saunders-Pullman","year":"1999","unstructured":"Saunders-Pullman R, Gordon-Elliott J, Parides M, Fahn S, Saunders HR, Bressman S: The effect of estrogen replacement on early Parkinson's disease. Neurology. 1999, 52: 1417-1421.","journal-title":"Neurology"},{"key":"1945_CR13","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.1002\/mds.21648","volume":"22","author":"LC Shih","year":"2007","unstructured":"Shih LC, Tarsy D: Deep brain stimulation for the treatment of atypical parkinsonism. Mov Disord. 2007, 22: 2149-2155. 10.1002\/mds.21648.","journal-title":"Mov Disord"},{"key":"1945_CR14","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1038\/33416","volume":"392","author":"T Kitada","year":"1998","unstructured":"Kitada T, Asakawa S, Hattori N, Matsumine H, Yamamura Y, Minoshima S, Yokochi M, Mizuno Y, Shimizu N: Mutations in the parkin gene cause autosomal recessive juvenile parkinsonism. Nature. 1998, 392: 605-608. 10.1038\/33416.","journal-title":"Nature"},{"key":"1945_CR15","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1002\/ana.21685","volume":"65","author":"SW Scholz","year":"2009","unstructured":"Scholz SW, Houlden H, Schulte C, Sharma M, Li A, Berg D, Melchers A, Paudel R, Gibbs JR, Simon-Sanchez J, Paisan-Ruiz C, Bras J, Ding J, Chen H, Traynor BJ, Arepalli S, Zonozi RR, Revesz T, Holton J, Wood N, Lees A, Oertel W, W\u00fcllner U, Goldwurm S, Pellecchia MT, Illig T, Riess O, Fernandez HH, Rodriguez RL, Okun M: SNCA variants are associated with increased risk for multiple system atrophy. Ann Neurol. 2009, 65: 610-614. 10.1002\/ana.21685.","journal-title":"Ann Neurol"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-5-599.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1752-1947-5-599\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-5-599","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-5-599.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T17:55:33Z","timestamp":1630518933000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/1752-1947-5-599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,12]]}},"alternative-id":["1945"],"URL":"https:\/\/doi.org\/10.1186\/1752-1947-5-599","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12]]},"assertion":[{"value":"26 July 2011","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2011","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2011","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"599"}}