Multiple System Atrophy

MULTIPLE SYSTEM ATROPHY (MSA) is so named because its signs and symptoms affect multiple parts of the body. It was previously called Shy-Drager syndrome (named after Doctors Shy and Drager), MSA is classified by two types: Parkinsonian and cerebellar, depending on which types of symptoms predominate at the time of evaluation.

Parkinsonian type

Predominant signs and symptoms are those of Parkinson’s disease, however, the symptoms appear much earlier on than they do in idiopathic Parkinson’s, such as:
• Rigid muscles and difficulty bending your arms and legs
• Slow movement (bradykinesia)
• Tremors (rare in MSA compared with classic Parkinson’s disease)
• Impaired posture and balance
• Incontinence

Cerebellar type
Predominant signs and symptoms are lack of muscle coordination (ataxia). Again, signs and symptoms appear much earlier on than they do in idiopathic Parkinson’s, and may include:
• Impairment of movement and coordination, such as unsteady gait and loss of balance
• Slurred, slow or low-volume speech (dysarthria)
• Visual disturbances, such as blurred vision and difficulty focusing your eyes
• Difficulty swallowing (dysphagia) or chewing
• Incontinence

General signs and symptoms
In addition, the primary sign of multiple system atrophy is:
• Postural (orthostatic) hypotension, a form of low blood pressure that makes the person feel dizzy, lightheaded, or even faint, when they stand up from sitting or lying down.
One can also develop dangerously high blood pressure levels while lying down.
People with multiple system atrophy may have other difficulties with body functions that occur voluntarily (autonomic), including:
• Loss of libido or impotence (in men)
• Incontinence or loss of bladder or bowel control
• Reduced production of perspiration, tears and saliva
• Body temperature changes often causing cold hands or feet as well as heat intolerance because of impaired sweating
• Constipation
• Irregular heartbeat
• Difficulty controlling emotions
• Agitated sleep due to “acting out” one’s dreams
• Abnormal breathing at night

Parkinson’s Resource Organization receives hundreds of calls, emails and letters every month relating to the diagnosis of Parkinson’s or the manifestation of symptoms. This article is posted on the PRO website as an informational courtesy and should not preclude the consult and subsequent advise of your medical professional. Always talk with your Doctor about your concerns.