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.
Problems with co-ordination, balance and speech
In MSA, a part of the brain called the cerebellum is damaged. This can make the person clumsy and unsteady when walking, and can also cause slurred speech. These problems are collectively known as cerebellar ataxia.
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.
MSA is one of a family of neurological disorders known as an atypical parkinsonian disorder. The initial symptoms can be difficult to distinguish from those of Parkinson's disease, and can include: Slowness of movement, tremor, or stiffness. Clumsiness or lack of coordination.
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.
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.
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.
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.
People typically live about 7 to 10 years after multiple system atrophy symptoms first appear. However, the survival rate with MSA varies widely. Death is often due to respiratory problems, infections or blood clots in the lungs (pulmonary embolus).
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.
Approximately 90 percent of individuals with MSA will experience parkinsonism symptoms including slowness of voluntary movements (bradykinesia), muscle stiffness (rigidity) which may make it difficult to bend the arms and/or legs, and impaired balance (postural instability).
The disease was first known as Shy-Drager Syndrome. Currently, it is believed that MSA is “sporadic,” meaning that there are no established genetic or environmental factors that cause the disease. A few reports have described families with MSA, but this finding is probably very rare.
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.
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.
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.
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.
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.
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.
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.
Autonomic Symptoms
Symptoms can include: Cold hands or feet and heat intolerance, because control of body temperature is impaired.
Red flags supporting the diagnosis of MSA include the following: Orofacial dystonia. Disproportionate antecollis. Severe anterior flexion of the spine (camptocormia)
Ocular findings in MSA are less common but are less recognized. These include ophthalmoplegia, excessive square-wave jerks,blepharospasm, hypometria of saccades, impaired smooth pursuit movement, pupillary defects, nystagmus, and reduced vestibular-ocular reflex.
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.