A Case of Multiple System Atrophy (MSA) – First Presentation in a Psychiatry Service

A 67 years old female developed cognitive deficits, depression and anxiety as first symptoms of multiple system atrophy (MSA). In the course of an year autonomic failure, parkinsonism and cerebellar ataxia also developed. The case is particular because of the somatic symptoms that were initially categorized as psychogenic, the presence of confusional and vertigo episodes that were recurring but not permanent.