Multiple system atrophy (MSA)
Multiple system atrophy (MSA)
Multiple system atrophy (MSA) is a rare neurological disorder that impairs your body's involuntary (autonomic) functions, including blood pressure, heart rate, bladder function and digestion. Formerly called Shy-Drager syndrome, the condition shares many Parkinson's disease-like symptoms, such as slowness of movement, muscle rigidity and poor balance.
Multiple system atrophy is a degenerative disease that develops in adulthood, usually in the 50s or 60s, and affects more men than women. The condition progresses gradually and eventually leads to death.
Treatment for MSA includes medications and lifestyle changes to help manage symptoms.
Multiple system atrophy is so named because its signs and symptoms affect multiple parts of your body. Previously called Shy-Drager syndrome, MSA is classified by two types: parkinsonian and cerebellar, depending on which types of symptoms predominate at the time of evaluation.
General signs and symptoms
You also can develop dangerously high blood pressure levels while lying down.
People with multiple system atrophy may have other difficulties with body functions that occur voluntarily (autonomic), including:
When to see a doctor
There's no known cause for brain changes in multiple system atrophy. Some researchers are studying whether there's an inherited component or environmental toxin involved in the disease process, but there's no substantial evidence to support these theories.
MSA is associated with deterioration and shrinkage (atrophy) of portions of your brain (cerebellum, basal ganglia and brainstem) that regulate internal body functions, digestion and motor control.
Evaluation under a microscope of damaged brain tissue of people with MSA reveals nerve cells (neurons) that contain an abnormal amount of a protein called alpha-synuclein. Some research suggests that this protein may be overexpressed in multiple system atrophy.
The rate of progression of multiple system atrophy varies from person to person, but the condition does not go into remission. As the disorder progresses, daily activities become increasingly difficult.
You may experience the following complications:
People typically live about six to 10 years after multiple system atrophy symptoms first appear, although some people with this condition have lived 15 years or longer. Death is often due to respiratory problems.
Preparing for your appointment
You're likely to start by seeing your family doctor, but you may be referred to a doctor who specializes in the diagnosis and treatment of conditions that affect the brain and nervous system (neurologist).
Here's some information to help you prepare for your appointment.
What you can do
For multiple system atrophy, some basic questions to ask your doctor include:
Don't hesitate to ask any other questions that occur to you.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Diagnosis of multiple system atrophy can be challenging because there's no test that can make or confirm the diagnosis. At the same time, certain signs and symptoms of MSA — such as muscle rigidity and unsteady gait — also occur with other disorders, such as Parkinson's disease, making the diagnosis more difficult. As a result, some people are never properly diagnosed, although doctors are increasingly aware of the disease and, thus, more likely to identify its symptoms.
If your doctor suspects multiple system atrophy, he or she will obtain a medical history, perform a physical examination, and possibly order blood tests and brain-imagining scans, such as an MRI, to determine whether brain lesions are present that may be triggering symptoms. You may receive a referral to a neurologist or other specialist for specific evaluations that can help in making the diagnosis.
Tilt table test
Throughout this maneuver, your blood pressure and heart rate are monitored. The findings can document not only the extent of blood pressure irregularities, but also whether they occur with a change in physical position.
Tests to assess autonomic functions
If you have sleep irregularities, particularly if they involve interrupted breathing or snoring, your doctor may recommend having you evaluated in a sleep laboratory to determine if you have an underlying and treatable sleep disorder, such as sleep apnea.
Treatments and drugs
There's no cure for multiple system atrophy. Management of the disease involves treating signs and symptoms to make you as comfortable as possible and to maintain your body functions and capabilities.
To treat specific signs and symptoms, your doctor may recommend:
A physical therapist can help you maintain as much of your motor and muscle capacity as possible as the disorder progresses. A speech-language pathologist can help you learn to improve or maintain your speaking ability.
Lifestyle and home remedies
Doctors often advise using certain self-care measures to help minimize symptoms associated with multiple system atrophy, such as:
Last Updated: 2011-07-02
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