Prognosis of multiple system atrophy--survival time with or without tracheostomy

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Rinsho Shinkeigaku 1999 May;39(5):503-7

[Prognosis of multiple system atrophy--survival time with or without

tracheostomy]

[Article in Japanese]

Kurisaki H.

Department of Neurology, National Tokyo Hospital.

Prognosis of 21 patients with multiple system atrophy (MSA) who deceased or

received tracheostomy is described. The percentage of patients with MSA

among

the cases of spinocerebellar degeneration was 40% in National Tokyo

Hospital.

There were 12 women and 9 men, and the mean age at onset was 56 years.

Seventy-four percent of MSA patients was olivopontocerebellar atrophy

(OPCA),

22% was striatonigral degeneration (SND). The mean age of 17 deceased

patients

(10 women, and 7 men) was 65.5 years. Ten patients did not undergo

tracheostomy

and deceased, and 11 patients underwent tracheostomy, among whom 4 patients

are

still alive. Mean duration of illness from onset to death (without

tracheostomy)

or tracheostomy was 6.8 years. Cause of death of patients who did not

undergo

tracheostomy was related to paresis of the larynx or pharynx, for example,

aspiration pneumonia due to dysphagia, vocal cord paralysis and sudden

death.

Some of those who underwent tracheostomy deceased for causes which were not

directly related to MSA such as cerebral hemorrhage or uremia, but others

seem

to be related to some problems of respiratory center such as central chronic

respiratory failure, or sudden death (sometimes it happened after infection,

but

the obstruction of the respiratory tract was not always present at autopsy).

PMID: 10424139 [PubMed - indexed for MEDLINE]