A person with MSA has much slower movements than normal (bradykinesia). This can make it difficult to carry out everyday tasks. Movement is hard to initiate, and the person will often have a distinctive slow, shuffling walk with very small steps. Some people may also have stiff and tense muscles.
There's no known cause for multiple system atrophy (MSA). Some researchers are studying a possible inherited component or involvement of an environmental toxin in the disease process, but there's no substantial evidence to support these theories.
MSA affects men and women equally, with an average age of onset of approximately 55 years [2, 3].
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. alpha-synuclein misfolds in MSA.
Its symptoms often mimic those of Parkinson's disease and ataxia. There is no cure, and many physicians are not familiar with the condition – meaning MSA is often misdiagnosed. However, symptoms can be managed, which is why it's important to be evaluated and treated by physicians who have experience dealing with MSA.
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.
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.
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.
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.
Rarely, the condition has been reported to run in families; however, it usually does not have a clear pattern of inheritance.
Several MRI abnormalities on conventional MRI already are included in the current diagnostic criteria for MSA. Other features on conventional MRI are also used to make a diagnosis of MSA or to rule out alternative diagnoses.
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.
There are currently no treatments to cure, slow down or reverse MSA. However, some medications and physical therapies may help your symptoms. Parkinson-like symptoms of slowness, stiffness, and tremor may improve with medications typically used for PD.
MSA Life Expectancy (Prognosis)
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.
Blood Tests
Individuals with MSA have near normal levels of a neurotransmitter called norepinephrine, which is used in the autonomic nervous system. This chemical is often decreased in PAF, and is used in some centers for diagnosis of PAF (peripheral)5. There are no diagnostic blood tests for MSA at present.
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.
Alongside the bladder difficulties, people with MSA also experience bowel difficulties.
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.
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.
However, in general, progression of MSA is much more rapid than in PD and about 50% of people with MSA are wheelchair bound 5-6 years after diagnosis. In addition, MSA is much less common than PD. For every person with MSA in the population, there are 40 people with PD.
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.
The range, severity, and distribution of symptoms vary greatly among affected individuals. For example, some may initially have only mild symptoms for several years; others may experience severe symptoms early in the course of the disease.