Multiple system atrophy Health Article

Definition

Multiple system atrophy (MSA) is a rare condition that causes symptoms similar to Parkinson's disease. However, patients with MSA have more widespread damage to the autonomic nervous system. This is the part of the nervous system that controls important organ functions such as heart rate, blood pressure, digestive system muscles, and sweating.

Alternative Names

Shy-Drager syndrome; Neurologic orthostatic hypotension; Shy-McGee-Drager syndrome; Parkinson's plus syndrome

Causes, incidence, and risk factors

The cause is unknown. MSA develops gradually and is most often diagnosed in men older than 60.

Symptoms

MSA damages the nervous system, which can cause the following symptoms:

• Changes in facial expression
  • "Mask" appearance to face
  • May be unable to close mouth
  • Reduced ability to show facial expressions
  • Staring
• Difficulty chewing or swallowing (occasionally)
• Disrupted sleep patterns (especially during rapid eye movement (REM) sleep late at night)
• Dizziness or fainting when standing up or after standing still
• Frequent falls
• Impotence
• Loss of control over bowels or bladder
• Loss of fine motor skills
  • Difficulty eating
  • Difficulty with any activity that requires small movements
  • Writing that is small and hard to read
• Loss of sweating in any part of the body
• Mild decline in mental function (may occur)
• Movement difficulties
  • Loss of balance
  • Shuffling
  • Walking pattern (gait) changes
• Muscle aches and pains (myalgia)
• Muscle rigidity
  • Difficulty bending arms or legs
  • Stiffness
• Nausea and problems with digestion
• Posture difficulties: may be unstable, stooped, or slumped over
• Slow movements
  • Difficulty beginning to walk or starting any voluntary movement
  • Freezing of movement when the movement is stopped, unable to start moving again
  • Small steps followed by the need to run to keep balance
• Tremors
  • May become severe enough to interfere with activities
  • May be worse when tired, excited, or stressed
  • May occur at rest or at any time
  • May occur with any action, such as holding a cup or other eating utensils
  • Finger-thumb rubbing (pill rolling tremor)
• Vision changes, decreased or blurred vision
• Voice and speech changes
  • Difficulty speaking
  • Monotone
  • Slow speaking
  • Voice is low volume

Other symptoms that may occur with this disease:

• Confusion
• Dementia
• Depression
• Sleep-related breathing difficulties, especially sleep apnea and a blockage in the air passage that leads to a harsh vibrating sound
• Seborrheic dermatitis