Neuropsychological assessment case study: Possible multiple systems atrophy

This case study describes the presentation, assessment, and emergent concerns surrounding ‘John’ (pseudonym), a right-handed white British man in his mid-50s admitted to an older adult Dementia and Frailty ward in October 2024. His admission followed a period of escalating cognitive, physical, and behavioural change characterised by rapid deterioration, unclear aetiology, and increasing risk. The case highlights the diagnostic challenges encountered when a younger individual presents with features suggestive of a neurodegenerative or rapidly progressive neurological condition.