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.
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.
Multiple system atrophy (MSA) affects many parts of your body. Symptoms usually start in adulthood, usually in the 50s or 60s. There are two types of MSA : parkinsonian and cerebellar. The type depends on the symptoms you have when you're diagnosed.
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.
Sleep disorders in patients with MSA include rapid eye movement sleep behavior disorder (RBD), excessive daytime sleepiness (EDS), and nocturnal sleep disturbances.
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.
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.
Red flags supporting the diagnosis of MSA include the following: Orofacial dystonia. Disproportionate antecollis. Severe anterior flexion of the spine (camptocormia)
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.
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.
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.
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.
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.
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.
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.
The presence of α-syn within oligodendrocytes in the form of glial cytoplasmic inclusions is the diagnostic hallmark of MSA.
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.
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.
The diagnostic accuracy was 71% in probable MSA and 60% in possible MSA. Correctly diagnosed patients with MSA had a younger age at onset and age at death than patients with PD or PSP, but duration of symptoms did not differ.
About 100% of patients with MSA had at least one non-motor symptom. The most frequently affected subdomains of NMS in MSA were gastrointestinal (95.1%), urinary (91.8%), sleep/fatigue (90.2%), sexual function (88.5%), and mood/apathy (88.5%) (Supplementary Table 1, Figure 1).
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.
Fatigue was prevalent in early-stage MSA, and it increased and remained persistent over time. This study demonstrated that OH and anxiety were associated with fatigue in patients with MSA.
One key difference is that the nerve destruction in Parkinson's tends to occur in the areas of the brain that control movement, whereas MSA affects what's called the autonomic nervous system.