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Previous Volume 351:912-922 August 26, 2004 Number 9 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 79-year-old woman was evaluated in a neurology clinic because of difficulty walking and cognitive changes.

The patient had been well until 18 months earlier, when she began to fall occasionally. There was no vertigo or witnessed seizure activity. Occasional memory lapses occurred, and she had difficulty performing her work as a sculptor. Six months after the first fall, her internist found that she had an abnormal tandem gait. Throughout most of her adult life, she had drunk approximately 5 oz (148 ml) of gin or vodka after dinner. The levels of vitamin B₁₂ and folate and the erythrocyte sedimentation . . . [Full Text of this Article]

Differential Diagnosis

Metabolic Disorders

Toxic Disorders

Microangiopathic Cerebrovascular Diseases

Neurodegenerative Diseases

            Atypical Parkinsonism with Early Cognitive or Psychiatric Changes

            Atypical Parkinsonism with Parkinson-Plus Features

Multiple-System Atrophy

Dr. Michael G. Schlossmacher's Diagnoses

Pathological Discussion

Discussion of Management

Anatomical Diagnoses

Source Information

From the Department of Neurology, Brigham and Women's Hospital (M.G.S.); the Departments of Neurology (M.G.S.), Medicine (C.H., A.G.C.), Radiology (R.G.G.), and Pathology (M.P.F.), Harvard Medical School; and the Geriatric Medicine Unit (C.H.), the Department of Radiology (R.G.G.), and the Division of Neuropathology, Department of Pathology (M.P.F.), Massachusetts General Hospital — all in Boston; and the Department of Medicine, MetroWest Medical Center, Natick, Mass. (A.G.C.).

Related Letters:

Case 27-2004: Multiple-System Atrophy
Schatz I. J., Goldstein D. S., Martin R. A., Schlossmacher M. G., Hamann C.
Extract | Full Text | PDF  
N Engl J Med 2004; 351:2881-2883, Dec 30, 2004. Correspondence

This article has been cited by other articles:

• Apostolova, L. G., Klement, I., Bronstein, Y., Vinters, H. V., Cummings, J. L. (2006). Multiple system atrophy presenting with language impairment.. Neurology 67: 726-727 [Full Text]  
• Schatz, I. J., Goldstein, D. S., Martin, R. A., Schlossmacher, M. G., Hamann, C. (2004). Case 27-2004: Multiple-System Atrophy. NEJM 351: 2881-2883 [Full Text]