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Definition

Multiple system atrophy (MSA) is a rare disease. It causes progressive damage to the nervous system. MSA is sometimes called a Parkinson’s plus syndrome because many of the symptoms are similar. MSA has debilitating effects on the body. Once symptoms develop the average life expectancy is ten years or less.

Nervous System

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These three diseases were once considered unrelated because their initial symptoms were different. However, they are now all considered MSAs.

  • Shy-Drager syndrome]]> —most prominent symptoms are in the autonomic system (actions that don’t involve conscious control, like blood pressure)
  • Striatonigral degeneration— ]]>Parkinson]]> -type symptoms such as slowed movements and rigidity
  • Olivopontocerebellar atrophy—affects balance, coordination, and speech

If you suspect you have this condition, contact your doctor promptly.

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Causes

The cause of MSA is unknown.

Risk Factors

These factors are associated with the development of MSA:

  • Men—affected twice as frequently as women
  • Age—the mean age that symptoms develop is 54 years of age

Symptoms

Symptoms of MSA can vary greatly. If you have any of these symptoms do not assume it is due to MSA. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Constipation]]>
  • Retention of urine
  • Loss of balance
  • Parkinsonism—symptoms like Parkinson’s disease: slower movements, tremor
  • Poor coordination
  • Abnormal eye movements
  • ]]>Orthostatic hypotension]]> —drop in blood pressure within minutes of standing up
  • ]]>Erectile dysfunction]]>
  • Swallowing problems
  • Breathing problems
  • ]]>Sleep apnea]]>
  • Shuffling
  • Slurred speech
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Diagnosis

Your doctor will ask about your symptoms and medical history. A neurological exam will be done. You will likely be referred to a specialist. Neurologists focus solely on the nervous system. Diagnosing MSA can be difficult. It usually means ruling out other diseases. For example, MSA can look like Parkinson’s disease but it generally progresses faster.

Tests may include the following:

  • MRI scan]]> —test that uses magnetic waves to form an image of structures inside the body; used to rule out other nervous system diseases and check for abnormalities in the brain that suggest MSA
  • Tests of autonomic function, such as measuring your heart rate and blood pressure under different circumstances, your response to a medicine called ]]>clonidine]]> , and an ]]>electromyogram]]> (a test using a needle to assess your muscles)
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Treatment

There is no specific treatment for MSA. Symptoms may be treated. Talk with your doctor about the best plan for you. Options include the following:

Medications

Various medications may be used to treat the symptoms of MSA:

  • Levodopa]]> —used to treat Parkinson’s disease; may be used to treat muscle rigidity
  • Increasing dietary salt and fluids, compression stockings, elevating the head of the bed, and medications that raise blood pressure may be used to treat hypotension
  • Other drugs may be used to treat the symptoms of ]]>constipation]]> , urinary, or erectile dysfunction
  • ]]>Continuous positive airway pressure]]> (CPAP) for ]]>sleep apnea]]> and other breathing problems during sleep

Physical Therapy

Therapy may be used to keep muscles strong and maintain range of motion.

Occupational Therapy

This therapy may be used to improve functions of daily living. This includes help with eating, grooming, and dressing.

Speech Therapy

This may help speaking and swallowing. A ]]>feeding tube]]> is sometimes inserted in later stages of MSA to deliver nutrition to the stomach.

Prevention

There are no known guidelines to prevent MSA.