Multiple System Atrophy

(MSA; Sporadic Olivopontocerebellar Atrophy; Shy-Drager Syndrome; Parkinson’s Plus Syndrome; Multi-system Degeneration; Multi-system Atrophy; Idiopathic Autonomic Failure; Idiopathic Orthostatic Hypotension;)

Definition

Multiple system atrophy (MSA) is a disorder of the nervous system.MSA is sometimes called a Parkinson’s 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.

Causes

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.
Nervous System
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Risk Factors

MSA tends to appear after 60 years of age.

Symptoms

Symptoms of MSA can vary greatly. Initial symptoms are similar to those of Parkinson disease. These initial symptoms may also be determined by the type of MSA:
  • Type MSA-A is associated with orthostatic hypotension. This is a problem managing blood pressure when moving from sitting to standing. It can lead to lightheadedness or fainting.
  • Type MSA-P is associated with symptoms similar to initial Parkinson symptoms such as:
    • Slow, stiff movements
    • Tremors
    • Clumsiness—loss of balance and coordination
    • Shuffling
  • Type MSA-C is associated with:
    • Difficulty swallowing
    • Problems speaking and hoarseness
    • 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:
  • Problems with bladder control
  • Erectile dysfunction
  • Muscle tightening around a joint that prevents free movement
  • Problems with posture, such as leaning to one side and forward head bend
  • Inappropriate laughing or crying
  • Excess yawning
  • Vision problems
  • Changes in writing

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