A rare cause of urinary retention - Multiple System Atrophy, a case report

Multiple system atrophy (MSA) is a rare neurodegenerative disorder with various combinations of pyramidal, extrapyramidal, cerebellar, or autonomic Involvement whose presentation can be any one of these making it difficult to diagnose unless it is considered. More frequently misdiagnosed as idiopathic Parkinsons disease which is subsequently revealed by poor response to levodopa. Here we report 70 year old man admitted with urinary retention which was due to autonomic involvement and also had pyramidal, extra pyramidal, cerebellar features.MR imaging of brain showed hot cross bun sign, so a diagnosis of multiple system atrophy was made