In the worst cases, failure of the breathing muscles and/or heart can lead to death. A therapy to combat the muscle wasting and weakness in MSA is needed urgently.
Other signs and symptoms
cold hands and feet. problems controlling sweating. muscle weakness in the body and limbs – it may be more pronounced in one arm or leg. uncontrollable laughing or crying.
The signs and symptoms are similar to those of Parkinson's disease, such as: Stiff muscles. Difficulty bending your arms and legs. Slow movement (bradykinesia)
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.
A person with MSA will have increased difficulty with movement and eventually become bedridden. People with MSA often develop swallowing problems that can lead to pneumonia in the later stages of the disease.
MSA damages the nervous system. 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.
Prognosis is currently guarded, with most MSA patients passing away from the disease or its complications within 6-10 years after the onset of symptoms.
Higher H-Y stage indicates a more severe neuromuscular state in MSA-P and is considered to be related to higher energy expenditure and decrease of BMI. Patients with MSA-P lose weight as the disease progresses.
Sleep disorders in patients with MSA include rapid eye movement sleep behavior disorder (RBD), excessive daytime sleepiness (EDS), and nocturnal sleep disturbances.
We found that 30 MSA patients (46.15%) suffered from pain. There was a trend towards a higher prevalence in MSA-P compared to MSA-C patients although the difference was not significant, which might be due to the small sample size. Few studies have investigated the pain mechanism in MSA patients.
What are the symptoms of MSA? Most often, the first clinical symptom a patient will note will be lightheadedness, dizziness, and episodes of passing out, but the first symptoms in some patients may include difficulty initiating movement, body stiffness, urinary incontinence, and increased falls.
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.
Up to 40% of MSA patients develop a peripheral neuropathy (PNP) [7–11].
As already mentioned, individuals with MSA undergo motor and muscle degeneration as the disease progresses. Physiotherapists can help maintain muscle range of motion and tone by using passive range of motion in combination with an exercise program that includes resistance training and/or gait/balance training.
Deconditioning – having MSA means a greater effort is needed to be mobile, this can lead to deconditioning of the muscles and the cardiovascular system, which in turn can lead to fatigue.
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.
This explains why some symptoms of MSA such as a tremor or speech difficulty can seem temporarily worse in stressful situations. Feeling anxious and worried is a familiar feeling for many people affected by MSA and it can easily become an unhelpful cycle.
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.
Autonomic Symptoms
Symptoms can include: Cold hands or feet and heat intolerance, because control of body temperature is impaired.
Eat high-omega-3, cold-water fish 2 to 3 times per week or supplement with omega-3 fatty acids. Sprinkle freshly ground flax seeds, a good vegetarian source of omega-3s, onto hot or cold cereal and drizzle flaxseed oil over salads and vegetables.
The progression of MSA varies, but the condition does not go into remission. As the disorder progresses, daily activities become more difficult. Possible complications include: Breathing problems during sleep.
Our findings show that smoking history and/or heavy alcohol use is associated with younger age of onset in MSA but do not influence survival.
Sudden death in MSA is hypothesized to be a consequence of disordered central respiration, suffocation caused by sputum and food, upper airway obstruction from NPPV acting on a floppy epiglottis, cardiac autonomic disturbance, or a combination of these factors.
Rarely, the condition has been reported to run in families; however, it usually does not have a clear pattern of inheritance.
Developing New Treatments for MSA and Its Symptoms
In the last 10 years, researchers at our center have led the development and approval of midodrine and droxidopa (Northera), two drugs now used for the treatment of orthostatic hypotension in people who have MSA.