J Korean Neurol Assoc.  2024 Nov;42(4):378-381. 10.17340/jkna.2024.0013.

Clinically Probable Multiple System Atrophy Presenting Ptosis as an Early Manifestation

• Yoo SW
• Jung H
• Lee K
• Kim J
• Jang M
• Yang EJ
• Kim JS

• KMID: 2560998
• DOI: http://doi.org/10.17340/jkna.2024.0013

Abstract

Many ocular features were found in patients with multiple system atrophy (MSA), which include dry eye, blepharospasm, eye movement problems, and blink reflex dysfunction. Some of these symptoms are associated with autonomic dysfunctions seen in MSA. We report a young clinically-probable MSA patient with bilateral ptosis at an early disease stage. Although there is no clear evidence that ptosis, in this case, was caused by abnormalities in the sympathetic cholinergic system, the selective impairment of sudomotor function implied an injured sympathetic cholinergic system secondary to MSA pathology. Ocular manifestations need more attention in clinical examinations of patients with MSA.

Keyword

Multiple system atrophy; Sympathetic cholinergic system; Blepharoptosis