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Anesthesia in Patients With Multiple-System Atrophy: A Narrative Review and Practice Guidance

Kumar, Chandra M. MBBS, FFARCSI, MSc, FRCA, EDRA, FAMS*; Seet, Edwin MBBS, MMed, FAMS*; Singh, Rohit Kumar; Joshi, Girish P. MBBS, MD, FFARCSI

doi: 10.1213/XAA.0000000000000939
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Multiple-system atrophy, a rare adult-onset neurodegenerative disease, is associated with autonomic dysfunction, features of parkinsonism, and cerebellar ataxia. This article discusses multiple-system atrophy pathophysiology, clinical presentation, and perioperative issues pertinent to anesthesia.

From the *Department of Anaesthesia, Khoo Teck Puat Hospital, Singapore

Students Office, National University of Singapore, Yong Loo Lin School of Medicine, Singapore

Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Accepted for publication November 1, 2018.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Address correspondence to Chandra M. Kumar, MBBS, FFARCSI, MSc, FRCA, EDRA, FAMS, Department of Anaesthesia, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828. Address e-mail to

Copyright © 2018 International Anesthesia Research Society
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