Shy-Drager syndrome presenting as depression: case report

Area of Science:

• Neurology
• Psychiatry
• Autopsy

Background:

• Shy-Drager syndrome is a rare neurodegenerative disorder.
• It is characterized by autonomic dysfunction, parkinsonism, and cerebellar ataxia.
• Subcortical neurologic disorders can present with psychiatric symptoms.

Observation:

• A patient presented with symptoms suggestive of a depressive disorder.
• Autopsy confirmed the diagnosis of Shy-Drager syndrome.
• The initial presentation masked the underlying neurological condition.

Findings:

• This case demonstrates that Shy-Drager syndrome can initially manifest as a depressive disorder.
• Affective disturbances may be an early sign of subcortical neurologic disorders.
• The diagnosis of Shy-Drager syndrome was initially missed due to its atypical presentation.

Implications:

• Shy-Drager syndrome should be considered in the differential diagnosis of unexplained depressive disorders.
• Early recognition of Shy-Drager syndrome is crucial for timely management.
• This case expands the understanding of the diverse clinical presentations of Shy-Drager syndrome.