Multiple system atrophy (MSA) is a common cause of atypical parkinsonism with a poor prognosis. MSA is associated with short survival but data from clinical or pathological studies are sparse and inconclusive. Factors predicting survival are not fully established.

This paper reports a study of survival and prognostic factors in the MSA-Aquitaine cohort (see Tison et al. J Neurol 1996, 153; Lancet, 2000, 495; Mov Disord, 2002: 1248 and 701) The study is retrospective. It focuses on an unselected cohort of patients from Aquitaine, based on the Consensus Conference statement on MSA diagnostic criteria, with prospective follow-up of mortality. All patients had a standard clinical examination. Disease history was collected through medical records and interviews of patients. Survival was ascertained by telephone.

From November 1, 1998 to April 1, 2002, «probable» or «possible» MSA was diagnosed in 86 patients (43 men; 43 women). Median survival from study inclusion was 2.4 years and 10.2 years from clinical onset, a result that is very similar to other series. Low age at study, diabetes mellitus, dysphagia, Hoehn and Yahr’s stage 5 all predict a shorter survival.

This report confirms the poor prognosis of MSA and that certain data may predict shorter survival.

45 references.