Sleep disorders in patients with MSA include rapid eye movement sleep behavior disorder (RBD), excessive daytime sleepiness (EDS), and nocturnal sleep disturbances. Previous studies showed that 69% to 100% of patients with MSA experience RBD.
It is documented that fatigue is a symptom of MSA and is prevalent in the early stages while remaining persistent over time. Everyone experiences MSA symptoms differently, and fatigue is no exception. Here are some signs to be mindful of: Weakness or feelings of heaviness, especially in the arms and legs.
In MSA, obstructive sleep apnea (OSA) occurs more frequently than central sleep apnea, ranging from 15 % to 37 % of the cases. CPAP is an effective treatment for eliminating obstructive sleep apnea in MSA patients, even if the adaptation to the device may be difficult in advanced cases.
People typically live about 7 to 10 years after multiple system atrophy symptoms first appear. However, the survival rate with MSA varies widely. Death is often due to respiratory problems, infections or blood clots in the lungs (pulmonary embolus).
In MSA there may be several stages -- alpha-synuclein accumulates in the oligodendroglial cells, then there is failure of mitochondrial function as well as loss of trophic factor support. Then the oligodendroglia degenerate, followed by microglia and astroglial activation.
Listen, listen, listen: Living with MSA can be very isolating. The family may be eager to talk about what they are going through so listening and showing empathy can be one of the most helpful things you can do. Or they may just want a light, fun evening with laughter. Pay attention to their cues and follow their lead.
Someone with MSA will often feel lightheaded, dizzy and faint after standing up. This is known as postural hypotension and is caused by a drop in blood pressure when you stand up or suddenly change position.
PD and MSA patients are prone to pain with insufficient treatment.
Though dementia is not considered a common characteristic of MSA, cognitive impairment occurs in some patients in the form of loss of verbal memory and verbal fluency1.
When you feel safer, because the 'danger' has passed or because you no longer fear it, your body returns to a more relaxed state. This explains why some symptoms of MSA such as a tremor or speech difficulty can seem temporarily worse in stressful situations.
Whilst MSA doesn't cause loss of sight, there are several symptoms that can occur. People living with MSA may display abnormal eye movements. Most commonly, this is a consequence of impaired or absent convergence, which is the ability to focus both eyes together. This may result in blurred or double vision.
Respiratory symptoms that the patients of MSA suffer include stridor, sleep-related breathing disorders, and respiratory insufficiency [2], with brainstem degeneration playing a probably main role [15].
Malnutrition is associated with higher mortality in the elderly population19 and MSA patients are frequently associated with weight loss20 and a malnutritional state8.
What bowel problems can occur when you have MSA? Constipation is the most common bowel problem experienced by people with MSA. However, a number of people with MSA will experience diarrhoea and some people have fluctuation between constipation and diarrhoea (see points 5, 7 and 9 below).
Definition. Multiple system atrophy- parkinsonian type (MSA-P) is a rare condition that causes symptoms similar to Parkinson disease. However, people with MSA-P have more widespread damage to the part of the nervous system that controls important functions such as heart rate, blood pressure, and sweating.
Autonomic Symptoms
All people with MSA have autonomic dysfunction, but it varies in severity from person to person. Symptoms can include: Cold hands or feet and heat intolerance, because control of body temperature is impaired.
Brain imaging scans, such as an MRI , can show signs that may suggest MSA and also help determine if there are other causes that may be contributing to your symptoms.
Physical Therapy and Exercise
Physical therapy can significantly improve motor symptoms through one-on-one exercises and personalized exercise plans. Many of the activities used to enhance movement of individuals with Parkinson's disease are used for people with MSA.
MSA affects men and women equally, with an average age of onset of approximately 55 years [2, 3].
Neither smoking history nor heavy alcohol use influenced overall survival in MSA patients.
However, in the last few years, cognitive impairment was found to be a frequent feature in MSA based on evidence from qualitative neuropsychological assessment. Dementia in MSA is now reported in 14-16% of cases.
This past March, the FDA granted the drug fast track designation for the treatment of MSA. “Biohaven sees the potential for verdiperstat to be the first disease-modifying treatment for MSA. No disease-modifying treatments currently exist for MSA; only symptomatic and palliative therapies are available,” Qureshi said.
A person with MSA experiences increasing difficulties with word finding and speech initiation, due to progressive neurological deterioration (Lieberman et al, 1992; Walsh & Smith, 2011). The rate of speech may also be slower compared to someone with Parkinson's disease (Huh et al, 2015).
MSA entails variable degrees of olfactory dysfunction, and at least some patients have a normal ability to distinguish among odors [14]. Whether olfactory dysfunction in the three synucleinopathies is related to cardiac noradrenergic or nigrostriatal dopaminergic denervation has not been assessed in the same study.