Multiple System Atrophy (MSA) is a rare, degenerative neurological disorder.
It results in the progressive deterioration of nervous system functioning along with Parkinsonian symptoms of poor balance, slow movement and rigid muscles.
There is no cure however lifestyle changes and medications help manage symptoms.
How MSA Impacts Movement and Involuntary Functions
MSA affects parts of your brain and the systems that control movement and involuntary actions such as blood pressure and bladder control. 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.
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. See information sheet – Atypical Parkinson’s.
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.
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 Therapists, 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 and therapy 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 Brain Foundation Australia brainfoundation.org.au or in the Multiple System Atrophy Information Kit on Parkinson’s Victoria’s website: www.fightparkinsons.org.au.
