DISEASE SUMMARIES at a glance
DISEASE SUMMARIES at a glance
Multiple System Atrophy( MSA)
• Rare disorder affecting multiple brain“ systems,” particularly those serving movement and autonomic control
• Originally described as three different diseases: Shy-Drager syndrome, striatonigral degeneration and sporadic olivopontocerebellar ataxia
• Pathologically classified as a synucleinopathy( accumulation of the protein alpha synuclein)
• Sub-classified by three core clinical features: parkinsonian, autonomic and cerebellar
• Three to four cases per 100,000 people
• Average age of onset is 54
• More common in men
• Life expectancy is seven to ten years after symptom onset
• No cure or medications to slow disease progression
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Signs and Symptoms
• Rigidity
• Action tremor: irregular, jerky, myoclonic movements
• Bradykinesia
• Freezing of gait
• Early postural instability and falls
• Orthostatic hypotension( low blood pressure on standing, sometimes with fainting)
• Erectile dysfunction
• Bladder dysfunction: urgency, frequency, incontinence
• Constipation
• Speech and swallowing difficulties: mixed dysarthria tends to emerge earlier in MSA than PD, is more severe and deteriorates more rapidly
• REM Behavioral Disorder( rbd): lack of normal muscle relaxation during dreaming
• Poor motor control resembling drunkenness
• Involuntary, rapid, rhythmic eye movements and jerky pursuit
• Antecollis
• Difficulty with thermoregulation
• Cognitive impairment is typically mild