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Initial presentation

Multiple system atrophy is a term for a degenerative type ofneurological disorder which is often abbreviated to MSA. It is commonly relatedto the processes of degeneration which occurs in the specific areas of thebrain and the nerve cells. As this degeneration takes place it causes numerousdifferent problems inside the human body concerning the balance and themovement along with certain autonomic controls such as the blood pressureregulation or bladder control. It is a quite peculiar fact that there are noknown causes of this medical condition and it cannot be related to any specifictypes of risk factors. Most people do not know that the multiple system atrophycommonly affects men much more than it does affect women. As far as age groupsare concerned, people who are in their late fifties or early sixties seem to beaffected by the condition more than those from other age groups. The mostcommon symptom and the actual first sign of the multiple system atrophy is theso called akinetic rigid syndrome. This is a term used for the slowness of theinitiation of movement which is very similar to Parkinson’s disease. There arealso certain other common medical problems which may be associated withmultiple system atrophy and those usually involve problems with balance,inability to achieve or sustain an erection and various problems with thebladder including inability to pass urine, incomplete bladder emptying,frequency and urgency. The combinationof unsteady walking, poor coordination, slow movement, tremor, muscle rigidityand autonomic dysfunction is commonly experienced by most people who sufferfrom multiple system atrophy.

Symptoms as disease progresses

As the disease slowly progresses, there are three maingroups of symptoms which dominate above the others. The first group of symptomsis referred to as Parkinsonism which is characterized by writing which becomesspidery and small, along with stiff and slow movement. The second group isreferred to as cerebral dysfunction and it is characterized by difficultycoordinating balance and movement. The third group of symptoms is calledautonomic dysfunction and it is characterized by a vast array of differenttypes of impaired automatic body functions. These may include REM behavior disorder,sleep apnea, inspirator stridor during sleep, abnormal breathing during sleep,trouble regulating body temperature due to abnormal sweating, dry skin, drymouth, vocal cord paralysis, constipation, impotence urinary retention, urinaryincontinence, fainting upon standing up, dizziness upon standing up,orthostatic hypotension, postural hypotension and various other sorts of sleepdisorders. There are also certain rare cases which have included other symptomssuch as double vision and significant cognitive impairment.

Diagnosis andTreatment

The process of diagnosis is quite challenging because thereare no particular tests which can be used to confirm the condition in apatient. This is mainly due to the fact that most symptoms usually occur withseveral other medical conditions, so it is quite hard to pinpoint the exactcase of multiple system atrophy. The only way to confirm the multiple systematrophy is to find the evidence of abundant amounts of glial cytoplasmicinclusions in the central nervous system. For now, there is no cure for themultiple system atrophy, so all different treatment methods available are aimedmainly at alleviating the symptoms of the condition. One needs proper care froma neurologist specialized in different types of movement disorders. Those whosuffer from this dreadful medical condition need to take fludrocortisones becausethey often suffer from drops in blood pressure upon standing up. This increasesthe risks of fainting and injuries from falling. This type of medicament isactually a synthetic type of mineralocorticoid. An alpha agonist known by thename of midodrine is also often used in the treatment of multiple systematrophy. There are also other non drug treatment options available such aspressure stockings, generous intake of fluids, increased intake of salt in thediet, salt tablets, and the head up tilt. It is of extreme importance to avoiddehydration, alcohol, hot weather and all other triggers of low blood pressure.Certain scientific studies have shown that the medication commonly used for thetreatment of Parkinson’s disease called levodopa can be of certain help in somecases of multiple system atrophy as well.


Rehabilitation is an essential part of the treatment for allthose who suffer from multiple system atrophy, especially those who haveproblems with speech, daily tasks, movement and walking. This requiresmanagement by different professionals which should include speech therapists,occupational therapists, physiotherapists, physiatrists and others. Thecontractures are prevented and the mobility is increased by utilizing physiotherapy.There are also certain mobility aids which need to be used in some cases.


Unfortunately, there is no remission from the multiplesystem atrophy, and it progresses much more quickly than the Parkinson’sdisease.

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