Demographic Data |
Relation to Proband |
No Data |
Age at Sampling |
58 YR |
Sex |
Male |
Age of Onset(If not a control) |
31 YR |
Age at Diagnosis(If not a control) |
53 YR |
Hispanic or Latino/Not Hispanic or Latino |
Not Hispanic/Latino |
Racial Category |
White |
Country |
USA |
Diagnosed By |
No Data |
|
Data Elements |
Clinical Element Type: Multiple System Atrophy |
(Baseline) |
Longitudinal Data |
Is this data Longitudinal (Follow-Up) Data? |
yes no |
Family History |
Family history of Multiple System Atrophy |
present absent Notes: FAMILY HISTORY OF MCLEOD SYNDROME, AFFECTED BROTHER, MOTHER IS CARRIER OF XK GENE MUTATION |
Best Clinical Diagnosis |
Progressive supranuclear palsy |
present absent |
Diffuse Lewy Body disease |
present absent |
Multiple system atrophy |
present absent |
Gaze palsy |
present absent |
Alzheimer's disease |
present absent |
Corticobasal ganglionic degeneration |
present absent |
Dementia |
present absent |
Other (specify) |
present absent Notes: MCLEOD SYNDROME, XK GENE MUTATION, CHOREA, SEIZURES, MILD COGNITIVE DECLINE, ELEVATED SERUM CREATINE PHOSPHOKINASE |
Signs suggestive of MSA diagnosis |
Orthostatic hypotension |
present absent |
Urinary incontinence |
present absent |
Incomplete bladder emptying |
present absent |
Bradykinesia |
present absent |
Rigidity |
present absent |
Postural Instability |
present absent |
Tremor |
present absent |
Gait ataxia |
present absent |
Ataxic dysarthria |
present absent |
Limb ataxia |
present absent |
Sustained gaze-evoked nystagmus |
present absent |
Extensor plantar responses with hyperreflexia |
present absent |
Features Suggestive of Another Diagnosis |
Responsive to Levodopa |
present absent |
Oculogyric crisis |
present absent |
Neuroleptic treatment onset |
present absent |
Hydrocephalus |
present absent |
Delusions |
present absent |
Early severe dementia |
present absent |
Whipple's disease |
present absent |
Focal sensory deficit |
present absent |
History of hypoxia/anoxia |
present absent |
History of alien limb syndrome |
present absent |
History of repeated strokes |
present absent |
History of encephalitis |
present absent |
Brain tumor |
present absent |
Prior history of repeated head injury |
present absent |
Optional data |
MSA Rating Scale Total Score |
No Data |