Multiple system atrophy (MSA) is a disorder of the nervous system. It leads to a gradual worsening of symptoms. Once symptoms develop, the average life expectancy is ten years or less.
MSA is sometimes called a Parkinson’s plus syndrome because many of the symptoms are similar. There are different types MSA based on the most apparent symptoms. One type was formerly known as Shy-Drager syndrome.
The cause of MSA is unknown. 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.
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Men are twice as likely to develop MSA than women. It tends to appear between 50-60 years of age.
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. Initial symptoms are similar to those of Parkinson disease. These initial symptoms may also be determined by the type of MSA:
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:
Your doctor will ask about your symptoms and medical history. A exam of the nervous system will also be done. You will likely be referred to a specialist.
Diagnosing MSA can be difficult. Other diseases will need to be ruled out. Tests to help rule out other diseases include:
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:
Dietary changes in salt and fluids may help manage orthostatic hypotension.
Soft or pureed foods may be helpful with swallowing problems.
A feeding tube may be needed in later stages of MSA. It will deliver nutrition directly to the stomach.
National Institute of Neurological Disorders and Stroke
National Dysautonomia Research Foundation
Shy-Drager/Multiple System Atrophy Support Group
Worldwide Education and Awareness for Movement Disorders
Canadian Institutes of Health Research
Canadian Neurological Sciences Federation
Multiple System Atrophy. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/msa/detail_msa.htm . Accessed April 19, 2013.
Multiple System Atrophy with Orthostatic Hypotension. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/msa/detail_msa.htm . Accessed April 19, 2013.
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 April 19, 2013.
Multiple System Atrophy. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 2, 2013. Accessed April 19, 2013.
Olivopontocerebellar Atrophy . National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/opca/opca.htm . Accessed April 19, 2013.
Overview of multiple system atrophy. Worldwide Education and Awareness for Movement Disorders website. Available at: http://www.wemove.org/msa/msa.html . Accessed April 19, 2013.
Last reviewed March 2013 by Rimas Lukas, MD; Michael Woods, MD
Last Updated: 3/18/2013