Symptoms tend to appear in a person's 50s and advance rapidly over the course of five to 10 years, with progressive loss of motor function and eventual confinement to bed. People with MSA often develop pneumonia in later stages of the disease.
Treatment includes medications and lifestyle changes to help manage symptoms, but there is no cure. The condition progresses gradually and eventually leads to death.
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.
Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disease with a mean survival of 6–10 years from disease onset1.
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).
Polyglutamine (polyQ) diseases such as spinocerebellar ataxias (SCA1, SCA2, SCA3, SCA6, SCA17, DRPLA) and also late-onset Huntington disease (HD) represent the most frequent genetic misdiagnosis due to the considerable clinical overlap with MSA [5].
During the final stages of the disease, patients have trouble chewing, swallowing, speaking and breathing.
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.
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.
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.
Multiple system atrophy (MSA) is a rare condition of the nervous system that causes gradual damage to nerve cells in the brain. This affects balance, movement and the autonomic nervous system, which controls several basic functions, such as breathing, digestion and bladder control.
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.
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 this unselected referral autopsy series of patients with antemortem diagnoses of MSA, the diagnostic accuracy was about 62%, which is within the range of other autopsy series.
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.
Neither smoking history nor heavy alcohol use influenced overall survival in MSA patients.
The prevalence of MS in Australia has increased from 103.7 per 100,000 people in 2017 to 131.1 per 100,000 people in 2021.
Indeed, a patient with MSA may present with vocal fold paralysis, and respiratory distress may be the initial symptom.
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.
Definition. Multiple system atrophy- parkinsonian type (MSA-P) is a rare condition that causes symptoms similar to Parkinson disease. However, people with MSA-P have more widespread damage to the part of the nervous system that controls important functions such as heart rate, blood pressure, and sweating.
MRI is useful and indispensable in the diagnosis of MSA and also possibly for monitoring disease progression.
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.
Most cases of multiple system atrophy are sporadic, which means they occur in people with no history of the disorder in their family. Rarely, the condition has been reported to run in families; however, it usually does not have a clear pattern of inheritance.