Consensus statement on the diagnosis of multiple system atrophy

J Neurol Sci. 1999 Feb 1;163(1):94-8. doi: 10.1016/s0022-510x(98)00304-9.


We report the results of a consensus conference on the diagnosis of multiple system atrophy (MSA). We describe the clinical features of the disease, which include four domains: autonomic failure/urinary dysfunction, parkinsonism and cerebellar ataxia, and corticospinal dysfunction. We set criteria to define the relative importance of these features. The diagnosis of possible MSA requires one criterion plus two features from separate other domains. The diagnosis of probable MSA requires the criterion for autonomic failure/urinary dysfunction plus poorly levodopa responsive parkinsonism or cerebellar ataxia. The diagnosis of definite MSA requires pathological confirmation.

Publication types

  • Consensus Development Conference
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Autonomic Nervous System Diseases / diagnosis
  • Cerebellar Ataxia / diagnosis
  • Diagnosis, Differential
  • Humans
  • Levodopa / therapeutic use
  • Multiple System Atrophy / classification
  • Multiple System Atrophy / diagnosis*
  • Multiple System Atrophy / physiopathology
  • Parkinson Disease / diagnosis
  • Urination Disorders


  • Levodopa