Multiple System Atrophy
(MSA; Sporadic Olivopontocerebellar Atrophy; Shy-Drager Syndrome; Parkinson Plus Syndrome; Multi-system Degeneration; Multi-system Atrophy; Idiopathic Autonomic Failure; Idiopathic Orthostatic Hypotension;)
by Cynthia M. Johnson, MA
Multiple system atrophy (MSA) is a disorder of the nervous system that gets worse over time. It affects the part of the nervous system that controls automatic functions like balance and coordination. This can lead to early death.
MSA is sometimes called a Parkinson plus syndrome because some symptoms are similar. There are different types of MSA.
MSA happens when nerve cells to break down in the brain and spinal cord. These nerves control automatic functions. The damage to the cells may be caused by a buildup of a certain protein. It is not known why this happens.
This problem is more common in men and people who are older than 54 years of age.
Symptoms vary from person to person and by type of MSA. At first, symptoms may be like that of Parkinson disease. They may also differ by type of MSA:
As MSA worsens, a person may have:
The doctor will ask about your symptoms and health history. A physical exam will be done. An exam of the nervous system will also be done. It will focus on the parts of the nervous system that control automatic functions. You will likely need to see a specialist.
Images may be taken. This can be done with an MRI scan.
There is no cure. The goal of treatment is to manage the symptoms a person has. Choices are:
Medicines may be given to ease problems like:
Some therapies that may be needed are:
Dietary changes may help manage symptoms. For example, soft foods may make it easier for people who have problems swallowing.
There are no known guidelines to prevent this health problem.
The Multiple System Atrophy Coalition
National Institute of Neurological Disorders and Stroke
Canadian Institutes of Health Research
Flabeau O, Meissner WG, et al. Multiple system atrophy: current and future approaches to management. Ther Adv Neurol Disord. 2010 Jul;3(4):249-263.
Multiple system atrophy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/multiple-system-atrophy. Accessed January 22, 2021.
Multiple system atrophy information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Multiple-System-Atrophy-Information-Page. Accessed January 22, 2021.
Multiple system atrophy orthostatic hypotension information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Multiple-System-Atrophy-Orthostatic-Hypotension-Information-Page/2796/organizations/1143. Accessed January 22, 2021.
Olivopontocerebellar atrophy information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Olivopontocerebellar-Atrophy-Information-Page. Accessed January 22, 2021.
Stefanova N. Translational therapies for multiple system atrophy: Bottlenecks and future directions. Auton Neurosci. 2017; doi: 10.1016/j.autneu.2017.09.016.
Last reviewed December 2020 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 1/22/2021