Background. MSA (Multiple System Atrophy) may be associated either with Parkinsonism or with cerebellar ataxia (MSA-c subtype). It is considered a rare disease, butmany patients are misdiagnosed as suffering from idiopathic Parkinson’s disease. In this paper, we report a case of a patient admitted with respiratory failure and vocal cords paralysis due toMSA-c. Case Report. A 79-yearold Caucasian woman was admitted in March 2010 with dyspnea, asthenia, stridor, and respiratory failure...