Multiple system atrophy (MSA): differential diagnosis
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Multiple system atrophy (MSA): differential diagnosis. MSA may be distinguished by the phalanx sign. Fully referenced neurology checklist.
Idiopathic late onset cerebellar ataxia (ILOCA)
- MSA may be distinguished by the phalanx sign
- This is observed during the finger-nose test of coordination
- The subject points at or below the distal interphalangeal joint instead of the fingertip
Parkinsonian disorders
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Other neurological disorders
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References
- Schneider V, Wirth T, Iosif A, et al. "Phalanx sign" helps to discriminate MSA-C from idiopathic late onset cerebellar ataxia. J Neurol 2022; 269:3900-3903.
- Stamelou M, Quinn NP, Bhatia KP. "Atypical" atypical parkinsonism: new genetic conditions presenting with features of progressive supranuclear palsy, corticobasal degeneration, or multiple system atrophy-a diagnostic guide. Mov Disord 2013; 28:1184-1199.
- Goh YY, Saunders E, Pavey S, Rushton E, Quinn N, Houlden H, Chelban V. Multiple system atrophy. Pract Neurol 2023; 23:208-221.
- Labate A, Nisticò R, Cherubini A, Quattrone A. Midbrain meningioma causing subacute parkinsonism. Neurol Clin Pract 2018; 8:166-168.
