Movement Disorders (revue)

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Therapeutic strategies in multiple system atrophy

Identifieur interne : 000F46 ( PascalFrancis/Curation ); précédent : 000F45; suivant : 000F47

Therapeutic strategies in multiple system atrophy

Auteurs : Gregor K. Wenning [Autriche] ; Felix Geser [Autriche] ; Werner Poewe [Autriche]

Source :

RBID : Pascal:05-0457535

Descripteurs français

English descriptors

Abstract

This review provides an update on therapeutic principles and their implications for practical management in multiple system atrophy (MSA), a sporadic neurodegenerative disorder characterized clinically by various combinations of dysautonomia, Parkinsonism, or cerebellar ataxia, often associated with other warning features (red flags), and pathologically by cell loss, gliosis, and glial cytoplasmic inclusions in selected multiple regions of the brain and spinal cord. Because of the small number of randomized controlled trials, the management of MSA is largely based on empirical or open-label evidence. Parkinsonism often shows a poor or unsustained response to chronic levodopa therapy, although more patients than previously recognized may experience an initial moderate-to-good dopaminergic response. There is no effective drug treatment for cerebellar ataxia. However, features of dysautonomia such as orthostatic hypotension, urinary retention or incontinence, constipation, and impotence, may often be relieved if recognized by the treating physician. Because no drug treatment consistently benefits patients with this disease in the long-term, palliative therapies are all the more important. Novel symptomatic and neuroprotective therapies are urgently required.
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A08 01  1  ENG  @1 Therapeutic strategies in multiple system atrophy
A09 01  1  ENG  @1 Atypical Parkinsonian Disorders
A11 01  1    @1 WENNING (Gregor K.)
A11 02  1    @1 GESER (Felix)
A11 03  1    @1 POEWE (Werner)
A12 01  1    @1 POEWE (Werner) @9 ed.
A12 02  1    @1 WENNING (Gregor K.) @9 ed.
A14 01      @1 Innsbruck Medical University, Clinical Department of Neurology @3 AUT @Z 1 aut. @Z 2 aut. @Z 3 aut.
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C01 01    ENG  @0 This review provides an update on therapeutic principles and their implications for practical management in multiple system atrophy (MSA), a sporadic neurodegenerative disorder characterized clinically by various combinations of dysautonomia, Parkinsonism, or cerebellar ataxia, often associated with other warning features (red flags), and pathologically by cell loss, gliosis, and glial cytoplasmic inclusions in selected multiple regions of the brain and spinal cord. Because of the small number of randomized controlled trials, the management of MSA is largely based on empirical or open-label evidence. Parkinsonism often shows a poor or unsustained response to chronic levodopa therapy, although more patients than previously recognized may experience an initial moderate-to-good dopaminergic response. There is no effective drug treatment for cerebellar ataxia. However, features of dysautonomia such as orthostatic hypotension, urinary retention or incontinence, constipation, and impotence, may often be relieved if recognized by the treating physician. Because no drug treatment consistently benefits patients with this disease in the long-term, palliative therapies are all the more important. Novel symptomatic and neuroprotective therapies are urgently required.
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C03 01  X  FRE  @0 Système nerveux pathologie @5 01
C03 01  X  ENG  @0 Nervous system diseases @5 01
C03 01  X  SPA  @0 Sistema nervioso patología @5 01
C03 02  X  FRE  @0 Atrophie multisystématisée @2 NM @5 02
C03 02  X  ENG  @0 Multiple system atrophy @2 NM @5 02
C03 02  X  SPA  @0 Atrofia multisistematizada @2 NM @5 02
C03 03  X  FRE  @0 Parkinsonisme @2 NM @5 03
C03 03  X  ENG  @0 Parkinsonism @2 NM @5 03
C03 03  X  SPA  @0 Parkinson síndrome @2 NM @5 03
C03 04  X  FRE  @0 Traitement @5 09
C03 04  X  ENG  @0 Treatment @5 09
C03 04  X  SPA  @0 Tratamiento @5 09
C03 05  X  FRE  @0 Stratégie @5 10
C03 05  X  ENG  @0 Strategy @5 10
C03 05  X  SPA  @0 Estrategia @5 10
N21       @1 318
N44 01      @1 OTO
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pR  
A30 01  1  ENG  @1 Atypical Parkinsonian Disorders - From Protein Dysfunction to Therapeutic Intervention. International Meeting @3 Innsbruck AUT @4 2003-02-19

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