Multiple system atrophy (MSA) is so named because its signs and symptoms affect multiple parts of your body. Previously called Shy-Drager syndrome, MSA is classified by two types: parkinsonian and cerebellar, depending on which types of symptoms predominate at the time of evaluation.
Predominant signs and symptoms are those of Parkinson's disease, 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
Predominant signs and symptoms are lack of muscle coordination (ataxia). Signs and symptoms 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 or double vision and difficulty focusing your eyes
- Difficulty swallowing (dysphagia) or chewing
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 you feel dizzy or lightheaded, or even faint, when you stand up from sitting or lying down.
You also can develop dangerously high blood pressure levels while lying down.
People with multiple system atrophy may have other difficulties with body functions that occur involuntarily (autonomic), including:
Urinary and bowel dysfunction
- Loss of bladder or bowel control (incontinence)
- A reduction in the production of perspiration, tears and saliva
- Impaired control of body temperature, often causing cold hands or feet as well as heat intolerance due to impaired sweating
- Agitated sleep due to "acting out" one's dreams
- Abnormal breathing at night
- Inability to achieve or maintain an erection (impotence)
- Loss of libido
- Difficulty controlling emotions
When to see a doctor
If you develop any of the signs and symptoms associated with multiple system atrophy, see your doctor for an evaluation and diagnosis. If you've already been diagnosed with the condition, contact your doctor if new symptoms occur or if existing symptoms worsen.
May 20, 2014
- Daroff RB, et al. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. https://www.clinicalkey.com. Accessed March 1, 2014.
- Ubhi K, et al. Multiple system atrophy: A clinical and neuropathological perspective. Trends in Neurosciences. 2011;34:581.
- Wenning GK, et al. The natural history of multiple system atrophy: A prospective European cohort study. The Lancet Neurology. 2013;12:264.
- Multiple system atrophy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/msa/detail_msa.htm. Accessed March 1, 2014.
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed March 1, 2014.
- Factor SA, et al. Multiple system atrophy: Prognosis and treatment. http://www.uptodate.com/home. Accessed March 4, 2014.
- FDA approves Northera to treat neurogenic orthostatic hypotension. U.S. Food and Drug Administration. http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm386311.htm. Accessed March 11, 2014.
- Sandroni P (expert opinion). Mayo Clinic, Rochester, Minn. March 11, 2014.
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