Objective: This study was done to describe the clinical profile of MSA and evaluate the cognitive function using mini-mental state examination(MMSE).

Background: Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by autonomic dysfunction with parkinsonism and ataxia. No previous studies have been published regarding MSA in Nepal and knowledge regarding their pattern of cognitive impairment is not clear.

Methods: Patient admitted in inpatient ward or presented in Outpatient ward from 2016 January to 2016 December in Neurology department of Tribhuvan University of Teaching Hospital with diagnosis of probable MSA were evaluated.

Results: Out of 38 patients with parkinsonism, 15 patients were identified with probable MSA; mean age was 63.2 years and mean age of symptoms onset was 58.4 years. Male patients were 12, and only 3 were female patients. Patients were referred to Neurologists in a mean duration of 6.5 months of symptoms onset. According to Clinical subtypes, 9 patients were MSA-C type and 6 patients were MSA-P type. Mean MMSE score in male patients was 26.5±2.23 and female patients was 27.0±1.73 (p=0.726). Among cognitive domains, attention was found to be impaired in 8 patients (53.3%) and memory in 5 patients (33.3%).

Conclusions: In our study, MSA is a common type of parkinsonism after Parkinson disease and male patients are predominant. Cognitive impairment, although not a commonly noticed feature of MSA, may present in mild form. MSA patients are usually initially treated by other specializations like urologists, cardiologists, gastroenterologists and otologists due to its various earlier non-motor clinical features.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-impairment-in-multiple-system-atrophy-a-nepalese-tertiary-center-study/