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.
It is documented that fatigue is a symptom of MSA and is prevalent in the early stages while remaining persistent over time. Everyone experiences MSA symptoms differently, and fatigue is no exception. Here are some signs to be mindful of: Weakness or feelings of heaviness, especially in the arms and legs.
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.
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.
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.
Malnutrition is associated with higher mortality in the elderly population19 and MSA patients are frequently associated with weight loss20 and a malnutritional state8.
PD and MSA patients are prone to pain with insufficient treatment.
When you feel safer, because the 'danger' has passed or because you no longer fear it, your body returns to a more relaxed state. This explains why some symptoms of MSA such as a tremor or speech difficulty can seem temporarily worse in stressful situations.
What bowel problems can occur when you have MSA? Constipation is the most common bowel problem experienced by people with MSA. However, a number of people with MSA will experience diarrhoea and some people have fluctuation between constipation and diarrhoea (see points 5, 7 and 9 below).
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.
Disease Overview
Multiple system atrophy (MSA) is a rare sporadic progressive neurological disorder characterized by a varying combination of symptoms and signs. Onset is during adulthood (>30 years).
Autonomic Symptoms
All people with MSA have autonomic dysfunction, but it varies in severity from person to person. Symptoms can include: Cold hands or feet and heat intolerance, because control of body temperature is impaired.
MRI is useful and indispensable in the diagnosis of MSA and also possibly for monitoring disease progression.
Indeed, a patient with MSA may present with vocal fold paralysis, and respiratory distress may be the initial symptom.
Having a diagnosis of MSA does not mean all possible symptoms will be experienced. Symptoms can change over time and progression will be individual. There is currently no cure or specific treatment to prevent MSA progressing but there are ways of helping to manage your symptoms.
Multiple system atrophy (MSA) is a rare neurological disease that causes certain brain areas to deteriorate. Over time, this disrupts abilities and functions handled by those brain areas. This disease is ultimately fatal.
Physical Therapy and Exercise
Physical therapy can significantly improve motor symptoms through one-on-one exercises and personalized exercise plans. Many of the activities used to enhance movement of individuals with Parkinson's disease are used for people with MSA.
MSA affects men and women equally, with an average age of onset of approximately 55 years [2, 3].
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.
Upper airway dysfunction associated with autonomic failure and dysfunction of the medullary serotonergic system, which regulates the cardiovascular and respiratory systems, could also be responsible for sudden death in patients with MSA [24, 25] since sudden death also occurred during the daytime.
MSA tends to progress more rapidly than Parkinson's disease, and most people with MSA will require an aid for walking, such as a cane or walker, within a few years after symptoms begin.
Neither smoking history nor heavy alcohol use influenced overall survival in MSA patients.
Based on comprehensive neuropsychological assessment, cognitive impairment was found to be a frequent feature in MSA, and clinically-defined dementia is now reported in 14-16% of cases.