Multiple system atrophy (MSA) is a disorder of the nervous system.
MSA is sometimes called a Parkinson plus syndrome because many of the symptoms are similar. There are different types MSA based on symptoms. Once symptoms develop, the average life expectancy is 10 years or less.
The cause of MSA is unknown. Genetic factors may play a role in some families.
The symptoms are caused by degeneration of nerves throughout the brain and spinal cord. These nerves control automatic functions like balance and muscle coordination. The damage to the nerve may be caused by a buildup of a specific protein, but this is not a confirmed cause.
Symptoms of MSA can vary greatly. Initial symptoms are similar to those of
disease. These initial symptoms may also be determined by the type of MSA:
Type MSA-A is associated with
orthostatic hypotension. This is where blood pressure drops when moving from sitting to standing. It can lead to lightheadedness or fainting.
Type MSA-P is associated with symptoms similar to initial Parkinson's symptoms such as:
Slow, stiff movements
Clumsiness—loss of balance and coordination
Type MSA-C is associated with:
Problems speaking and hoarseness
Trouble breathing due to tightness in throat
Difficulty coordinating muscle movement
As the disease progresses, symptoms will cross over types and become more severe. Many will develop muscle coordination problems and need walking aids. Other problems that may exist across type include:
Muscle tightening around a joint that prevents free movement
Problems with posture, such as leaning to one side and forward head bend
Trouble with sweating
Inappropriate laughing or crying
Changes in writing
You will be asked about your symptoms and medical history. An exam of the nervous system will also be done. You will likely be referred to a specialist.
Tests may include:
Testing of owel and bladder function
Images may be taken of your bodily structures. This can be done with an
Tests will also be done on your heart rate and blood pressure. These tests will help determine what is causing problems with your autonomic nervous system. Nerve impulses to your muscles may also be tested.
There is no cure for MSA. Treatment will focus on managing the symptoms and supportive care. Talk with your doctor about the best plan for you. Options include the following:
Various medications may be used to manage the symptoms of MSA. Medication may be given to:
Relieve muscle rigidity
Manage orthostatic hypotension
Relieve other symptoms such as constipation, urinary control problems, or erectile dysfunction
Physical therapy—to help keep muscles strong and maintain range of motion
Occupational therapy—to improve ability to do daily tasks such as eating, grooming, and dressing
Speech therapy—to help with speaking and swallowing
Multiple system atrophy fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Multiple-System-Atrophy-Information-Page. Accessed November 9, 2017.
Multiple system atrophy/Shy-Drager syndrome. Vanderbilt University Medical Center website. Available at: http://www.mc.vanderbilt.edu/root/vumc.php?site=adc&doc=4791. Accessed November 9, 2017.
NINDS multiple system atrophy with 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. Accessed November 9, 2017.
NINDS 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 November 9, 2017.
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 November 2018 by
EBSCO Medical Review Board
Rimus Lukas, MD
Last Updated: 1/20/2015
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