Multiple System Atrophy (MSA)

What is multiple system atrophy (MSA)?

Multiple system atrophy (MSA) is a rare disorder that affects the autonomic system. Being a neurological disease, it impairs the motor, coordination, and balance centers in the brain. Additionally, blood pressure, heart rate, and digestion are not regulated. There are two types of MSA, identified based on the predominate symptoms: parkinsonian and cerebellar. MSA affects 2-5 people per 100,000, usually in adults aged 55 or older.  On average, patients survive for about 10 years after symptoms appear.

What are the symptoms of MSA?

General MSA symptoms include:

• Postural orthostatic hypotension
• Bladder problems
• Disrupted sleep
• Sexual dysfunction
• Irregular heartbeat
• Emotional disturbances

Parkinsonian MSA symptoms are:

• Difficulty bending arms and legs
• Tremors
• Lack of balance
• Difficult or slow movement

Cerebellar MSA symptoms are:

• Difficulty moving and balancing
• Slurred or slow speech
• Visual impairment
• Difficulty swallowing

What causes MSA?

While MSA is associated with the shrinking of parts of the brain, the cause of MSA is unknown. It is possibly inherited or due to environmental factors, but there is no substantial evidence for either.

How is MSA diagnosed?

MSA can be challenging to diagnose because there is no simple blood test. Rather, a clinical diagnosis is used. Since it mimics many other diseases, such as Parkinson’s, it can be even more difficult to identify. Doctors may perform the following tests to help inform the diagnosis:

• Tilt table tests
• MRI or brain imaging scans
• Physical exam
• Medical history
• Blood pressure measurement
• Sweat exam
• Bladder exam
• Eye exam
• Nerve exams

What treatment options are available for MSA?

MSA treatment aims to control symptoms, since there is no cure for the disease.

• Blood pressure medications
• Anti-Parkinson’s medication
• Swallowing and breathing therapy
• Bladder drugs
• Pacemaker
• Sexual dysfunction drugs

Where can I find out more about multiple system atrophy (MSA)?

• Mayo Clinic
• NIH
• The MSA Coalition