![][1] It is now 50 years since Graham and Oppenheimer first coined the term multiple system atrophy (MSA).1 Twenty years later, I wrote an extensive review of MSA entitled ‘The nature of the beast’.2 This alluded to blindfolded men examining an elephant from different directions and coming away with different perceptions (figure 1). Not long ago, a propos of MSA, my uroneurologist friend Clare Fowler (personal communication), commented, “You know, it all makes sense now, but 30 years ago that was far from being the case.” Figure 1 The MSA Elephant. I got hooked on neurology, and on movement disorders in particular, in my first neurology post as SHO to David Marsden at King’s College Hospital. Later, I worked for Roger Bannister at Queen Square, where I encountered a number of severely affected inpatients with MSA. I read the papers of Dejerine and Thomas3 on sporadic olivopontocerebellar degeneration (sOPCA, now MSA-C), Bradbury and Eggleston4 on postural hypotension, Shy and Drager (1960) on their syndrome (Shy-Drager5 syndrome; SDS), and of Adams et al 6 on striatonigral degeneration (SND now MSA-P). Other key developments in the busy 1960s (which I still think of as the decade of the basal ganglia) were the introduction of levodopa in 1967, Hoehn and Yahr’s landmark (pre-levodopa) 1967 paper7 on a large cohort with Parkinson’s disease and parkinsonism, Steele et al ’s description of their syndrome,8 later called progressive supranuclear palsy (PSP) and Rebeiz et al ’s paper on corticodentatonigral degeneration, now called corticobasal degeneration (CBD).9 Later, in 1972, Bannister and Oppenheimer had described in Brain 10 16 pathologically confirmed cases of neurogenic autonomic … [1]: /embed/graphic-1.gif

中文翻译：

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多系统萎缩：重访野兽的本质。


[] [1]距离Graham和Oppenheimer首次提出多系统萎缩（MSA）一词至今已有50年。1二十年后，我写了一篇题为“野兽的本质”的MSA详尽综述。2蒙着双眼的人从不同的方向检查大象并以不同的感知消失（图1）。不久前，我的泌尿外科专家朋友克莱尔·福勒（Clare Fowler）（个人交流）对MSA的提议进行了评论：“您知道，现在这一切都说得通了，但30年前远非如此。” 图1 MSA大象。我在国王学院医院的大卫·马斯登（David Marsden）担任SHO的第一份神经科职位中就迷上了神经病学，尤其是运动障碍。后来，我在皇后广场（Queen Square）的罗杰·班尼斯特（Roger Bannister）工作，在那里我遇到了许多严重受影响的MSA住院病人。我读了Dejerine和Thomas3关于散发性少突性小脑小脑变性（sOPCA，现为MSA-C），Bradbury和Eggleston4关于姿势性低血压的论文，Shy和Drager（1960）关于其综合征（Shy-Drager5综合征； SDS）以及Adams等的论文。 [6]关于纹状体黑质变性的研究（SND现为MSA-P）。在繁忙的1960年代（我仍然认为这是基底神经节的十年）中的其他重要发展是1967年引入左旋多巴，Hoehn和Yahr的标志性论文（左-左旋多巴）1967年发表在有关帕金森氏病和帕金森氏病的大型队列中斯蒂尔（Steele）等人对它们的综合征的描述8后来被称为进行性核上性麻痹（PSP），而瑞贝兹（Rebeiz）等人的关于皮质五角膜变性的论文，现在称为皮质基底变性（CBD）。9后来，在1972年，