A 42-year-old woman presents with a 6-year history of progressive rigidity, dysarthria, and frequent episodes of sudden-onset involuntary muscle contractions causing abnormal neck and trunk posturing. She reports constipation, urinary urgency, and orthostatic dizziness. On examination, she has generalized bradykinesia, cogwheel rigidity, and hyperreflexia. Brain MRI demonstrates atrophy of the putamen and midbrain tegmentum. Which of the following is the most likely diagnosis?
- A)Multiple system atrophyGABARITO
- B)Parkinson disease with secondary dystonia
- C)Progressive supranuclear palsy
- D)Wilson disease
- E)Primary dystonia with Parkinsonian features
Explicação
Multiple system atrophy (MSA) is characterized by the constellation of findings in this patient: autonomic dysfunction (orthostatic hypotension, urinary symptoms, constipation), Parkinsonian features (rigidity, bradykinesia, dysarthria), and cerebellar signs. ... Ver explicação completa e trilha adaptativa →