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.
Typical ocular features of MSA include blepharospasm, excessive square-wave jerks, mild to moderate hypometria of saccades, impaired vestibular-ocular reflex (VOR), nystagmus and impaired event-related evoked potentials.
Ocular findings in MSA are less common but are less recognized. These include ophthalmoplegia, excessive square-wave jerks,blepharospasm, hypometria of saccades, impaired smooth pursuit movement, pupillary defects, nystagmus, and reduced vestibular-ocular reflex.
During the final stages of the disease, patients have trouble chewing, swallowing, speaking and breathing.
The disease tends to progress rapidly. About one half of people with MSA-P have lost most of their motor skills within 5 years of onset of the disease.
Sleep and breathing problems are very common in MSA patients. Sleep apnea (momentary lapses in breathing), respiratory stridor (noisy breathing), REM behavior disorder (shouting and acting out dreams) and excessive daytime sleepiness can be among the earliest symptoms of MSA.
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.
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).
Symptoms tend to appear in a person's 50s and advance rapidly over the course of five to 10 years, with progressive loss of motor function and eventual confinement to bed. People with MSA often develop pneumonia in later stages of the disease.
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.
Based on comprehensive neuropsychological assessment, cognitive impairment was found to be a frequent feature in MSA, and clinically-defined dementia is now reported in 14-16% of cases.
Systemic sclerosis (SSc) is a rare, chronic autoimmune disease with unknown etiology. Its prominent features are fibrosis, vasculopathy and impaired immune response. Disease can also affect eyes leading to various findings in ophthalmological examination.
MRI is useful and indispensable in the diagnosis of MSA and also possibly for monitoring disease progression.
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.
In this unselected referral autopsy series of patients with antemortem diagnoses of MSA, the diagnostic accuracy was about 62%, which is within the range of other autopsy series.
Appetite reduces and weight loss is apparent. Communication becomes too effortful and breathing more bubbly or shallow. Dying is very rarely a dramatic event. In the majority of cases it is an increasing winding down of all bodily functions and everything stopping, death occurring in a peaceful and dignified manner.
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.
Disease Overview
Multiple system atrophy (MSA) is a rare sporadic progressive neurological disorder characterized by a varying combination of symptoms and signs. Onset is during adulthood (>30 years).
Multiple system atrophy (MSA) is a rare neurological disease that causes certain brain areas to deteriorate. Over time, this disrupts abilities and functions handled by those brain areas. This disease is ultimately fatal.
Malnutrition is associated with higher mortality in the elderly population19 and MSA patients are frequently associated with weight loss20 and a malnutritional state8.
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.
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).
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.
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.