Multiple System Atrophy

Multiple System Atrophy (MSA) is a rare, degenerative neurological disorder.

There is no cure however staying active, eating well, and working closely with your care team can make a real difference.

Understanding MSA

MSA is a rare condition that affects how the nervous system works. Over time, it can lead to changes in movement and balance. People living with MSA may notice symptoms similar to Parkinson’s, such as slower movements, stiff muscles, and trouble keeping steady. An estimated 1,200 Australians live with the condition.

Symptoms usually show up in people between the ages of 50 and 60. It is seen slightly more frequently in males; however, females, younger and older cases have occurred.

While there is currently no cure for MSA, there is hope. With the right support, lifestyle changes, and medications, many people find ways to manage their symptoms and improve their quality of life. Staying active, eating well, and working closely with your care team can make a real difference.

How MSA impacts movement & involuntary functions

People living with MSA may experience symptoms similar to Parkinson’s, such as slow movement, stiff muscles, and poor balance. But MSA also impacts involuntary functions, things our bodies do without us thinking, like blood pressure control, digestion, bladder function, and even breathing.

Causes

Currently, there’s no known cause or genetic links associated with MSA. MSA causes deterioration and shrinkage (atrophy) of portions of your brain (cerebellum, basal ganglia and brainstem) that affect internal body functions and motor control.

Symptoms

Symptoms and progression varies from person to person. Generally, orthostatic hypotension, which is low blood pressure, light-headedness, dizziness is present in all MSA cases. Depending on which part of the brain is affected first, it may present looking more like Parkinson’s, with:

urinary and bowel problems
impotence (problems with erections)
balance problems leading to falls.

The Parkinsonian symptoms such as muscle stiffness and slower movement may be on both sides of the body rather than on one.

Other symptoms and common complaints include:

issues with heat tolerance and body temperature control
producing less sweat
cold hands and feet
swallowing and chewing difficulties
noisy breathing especially at night
softer voice
slurred speech
losing bladder control (incontinence)
difficulties with vision including focusing.

Diagnosis

A diagnosis is made on medical history and nervous system examination. However, diagnosing MSA can be challenging.

A scan may help determine between MSA and the other atypical Parkinsonism conditions.

MSA has little or no response to levodopa although some people may get a short-lived or partial positive response.

You may also be asked to do a sleep study to diagnose any treatable sleep disorders, like REM Sleep Behaviour Disorder.

Your care

As the disorder progresses, daily activities become more difficult. Assembling a care team early can help you live well longer. Be sure to include Occupational Therapists (OTs), Speech Pathologist, and Palliative Care. Because the condition does not respond well, or at all, to levodopa, allied health support is essential to maintain mobility, balance, and safety.

Medical and medication management may reduce Parkinsonian symptoms, low blood pressure, impotence drugs, and constipation.
OT assessments can help maintain functional independence and ensure home safety.
Speech and swallowing assessment by a speech pathologist will address speech and swallowing symptoms. However, an alternative communication aid may be needed.
Parkinson’s nurse specialists are familiar with this condition and can support the person with MSA and their family.

Further information can be found through the Combat MSA on https://www.combatmsa.org.au/