Diagnosis of multiple system atrophy (MSA) can be challenging because there's no test that can make or confirm the diagnosis. At the same time, certain signs and symptoms of MSA — such as muscle rigidity and unsteady gait — also occur with other disorders, such as Parkinson's disease, making the diagnosis more difficult.
As a result, some people are never properly diagnosed, although doctors are increasingly aware of the disease and, thus, more likely to identify its symptoms.
If your doctor suspects multiple system atrophy, he or she will obtain a medical history, perform a physical examination, and possibly order blood tests and brain-imaging scans, such as an MRI, to determine whether brain lesions are present that may be triggering symptoms.
You may receive a referral to a neurologist or other specialist for specific evaluations that can help in making the diagnosis.
Tilt table test
One procedure that can aid in the diagnostic process is a tilt table test to help determine if you have a problem with blood pressure control. In this procedure, you're placed on a motorized table and strapped in place. Then the table is tilted upward so that your body is nearly vertical.
Throughout this maneuver, your blood pressure and heart rate are monitored. The findings can document not only the extent of blood pressure irregularities but also whether they occur with a change in physical position.
Tests to assess autonomic functions
Doctors may order certain other tests, to determine how your body is functioning. Tests to assess your body's involuntary functions may include:
- Blood pressure measurement, lying down and standing
- A sweat test to evaluate perspiration
- Eye exam
- Tests to assess your bladder and bowel function
- Electrocardiogram to track the electrical signals of your heart
- Nerve and muscular examination
If you have sleep irregularities, particularly if they involve interrupted breathing or snoring, your doctor may recommend having you evaluated in a sleep laboratory to determine if you have an underlying and treatable sleep disorder, such as sleep apnea.
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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