Multiple System Atrophy (MSA) is a rare, progressive neurodegenerative disorder that affects the body’s autonomic nervous system (which controls automatic functions like blood pressure and bladder control), along with movement, coordination, and balance.
MSA is often misdiagnosed early on as Parkinson’s disease, but it progresses more rapidly and involves additional systems in the body.
Types of MSA
There are two main types:
- MSA-P (Parkinsonian type) – symptoms are similar to Parkinson’s disease (rigid muscles, slowness, tremor).
- MSA-C (Cerebellar type) – symptoms include problems with coordination, walking, speech, and balance.
Common Symptoms
- Muscle stiffness and slowness (like Parkinson’s disease)
- Poor balance and frequent falls
- Slurred or quiet speech
- Impaired coordination and gait problems
- Low blood pressure (especially when standing up – orthostatic hypotension)
- Urinary urgency, incontinence, or retention
- Erectile dysfunction
- Difficulty swallowing
- Breathing abnormalities (especially during sleep)
Diagnosis
There is no single test to confirm MSA. Diagnosis is based on:
- Detailed neurological evaluation
- Brain imaging (MRI may show characteristic changes)
- Autonomic testing (blood pressure, sweating, bladder studies)
- Sleep studies (to assess breathing or REM sleep abnormalities)
- Ruling out other conditions like Parkinson’s, cerebellar ataxias, or multiple sclerosis
Treatment Options
There is no cure for MSA, but treatment focuses on managing symptoms and improving quality of life.
Medication Management
- Parkinsonian symptoms: May respond to levodopa, though usually less effectively than in Parkinson’s disease.
- Low blood pressure: Treated with midodrine, fludrocortisone, increased salt and fluid intake, or compression garments.
- Bladder symptoms: Managed with medications like oxybutynin, catheters, or urodynamic evaluations.
- Erectile dysfunction: Treated with PDE5 inhibitors (e.g., sildenafil).
- Sleep issues or REM behavior disorder: May be treated with melatonin, clonazepam, or CPAP if sleep apnea is present.
Supportive Therapies
- Physical therapy – to maintain mobility and prevent falls
- Speech therapy – for speech clarity and safe swallowing
- Occupational therapy – for daily activity adaptations
- Nutrition counseling – to avoid weight loss and aspiration
- Counseling and social support – for mood, stress, and future planning
Advanced Care Planning
Because MSA is progressive, early conversations about:
- Medical power of attorney
- Goals of care
- End-of-life planning can help ensure your wishes are honored.
Living with MSA
At NeuroMotion Telehealth, we understand the complexities of MSA and are here to help you manage the journey.
At NeuroMotion, we provide:
- Certified Nurse Practitioner Movement Disorder Specialists
- Virtual medication and symptom management
- Home safety assessments and therapy referrals
- Regular check-ins to monitor symptom progression
- Compassionate support for patients and families
If you or a loved one has been diagnosed with MSA, we are here to guide you. Early intervention and consistent support can make a meaningful difference.