2020 Volume 57 Issue 2 Pages 151-155
A 69-year-old man noticed unsteadiness of gait from 2006, and was diagnosed as having multiple systems atrophy (MSA-C) in 2008 since cerebellar ataxic and static hypotension was found in addition to characteristic MRI findings. In January 2018, because of clouding of consciousness and a temperature of 32.2 degrees, he was admitted to another hospital. The clouding of consciousness and hypothermia immediately improved on general warming. Because clouding of consciousness and hypothermia also occurred in March, he was admitted to our hospital for further examination. On admission, he had cerebellar dysarthria, walking disability due to incoordination of the limbs and urinary incontinence. CVR-R was normal, and a sympathetic skin response was not confirmed. The baselines of skin blood flow in his upper limbs were high, and a blood flow decrease response was not confirmed on electrical stimulation, but was confirmed on deep breathing. Thermography showed the temperature of his upper limbs was relatively high, but his trunk temperature was low. This case had MSA-C with Shapiro's syndrome, and since the patient's skin blood volume of the upper limbs was elevated and the skin temperature was high, but there was little skin blood flow decrease reactions, it was speculated that repeated hypothermia may have occurred because his body temperature was easily influenced by the outside temperature.
