Hot cross bun and bright middle cerebellar peduncle signs in cerebellar type multiple system atrophy

Description

A 52-year-old female patient presented with progressive gait unsteadiness for 6 months. Over the months, it has worsened to such an extent that she required support for walking. She also complained of frequent episodes of light-headedness on standing up from lying down or sitting down. She had no urge incontinence, urinary retention, increased frequency of micturition or constipation. She had no bradykinesia, rigidity, memory loss or features suggestive of dementia. There was no family history of similar complaints or dementia. On examination, she was found to have gait ataxia, nystagmus and intention tremors. The gait was broad based with sway towards left side. Her eye movements showed dysmetric saccades and jerky pursuit. She was also found to have postural hypotension. Her supine blood pressure was 170/90 mm Hg and her standing blood pressure was 140/70 mm Hg. She had no resting tremor, rigidity or bradykinesia. Babinski's sign was negative....

http://ift.tt/2h2r4kW