cerebellar ataxia symptoms, meaning balance and coordination trouble. People with this subtype may be misdiagnosed with other forms of cerebellar ataxia initially, particularly genetic or inflammatory conditions. Typically, people living with MSA over time will develop at least some degree of symptoms in both subtypes, though one will often remain more prominent. Both of these subtypes share the same pathology in the brain, with abnormal buildup of the same protein( alpha-synuclein) in brain cells. Depending on where in the brain the buildup starts, people will exhibit one MSA subtype or the other.
What other symptoms can occur in MSA? While each individual with MSA can present with their own unique symptoms and progression, there are commonalities for many people living with this diagnosis.
As the disease progresses, people with MSA often experience mobility and balance problems that can eventually require assistance in walking or even a wheelchair. People can also develop difficulty using their hands to write, button clothing, dress themselves, feed themselves, and perform other activities required for daily living. People with MSA of the parkinsonian type tend to get more muscle stiffness and general slowness. Those with the cerebellar type develop difficulty aiming their limb movements or walking in a straight line.
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People with MSA often develop problems with their autonomic nervous system. The autonomic nervous system takes care of things you don’ t have to think about, such as blood pressure, heart rate, sweating, emptying the bladder or bowels, and sexual function. People with this problem may notice symptoms such as lightheadedness or even fainting with standing and walking, constipation, loss of control of urinary function, or sexual dysfunction.
Sometimes breathing can also be affected. This can include irregular breathing or temporary cessation of breathing while sleeping( sleep apnea) and a loud noise when taking in a breath( inspiratory stridor). Treatment of these symptoms often involves the use of a continuous positive airway pressure( CPAP) or bilevel positive airway pressure( BiPAP) machine, which pushes oxygenated air into the nose or mouth via a mask during sleep. In addition to sleep apnea, some people with MSA experience other sleep disturbances such as abnormal movements during sleep, acting out dreams while asleep, restless leg syndrome, and frequent awakenings during the night. Your doctor may recommend a sleep study to monitor for these symptoms.
People with MSA may develop difficulty with speaking. This difficulty can manifest as soft speech or slurred speech. Swallowing can also become difficult and may require people to alter the consistency of their food or to take special precautions while eating. For these reasons, your doctor may recommend that you participate in regular evaluations and treatment with a speech-language pathologist. In some cases, if swallowing becomes very difficult, people may choose to get a special tube placed into the stomach for feeding.
Visual symptoms can also occur, the most common of these being dry eyes and double vision. These can be addressed with a neuro-ophthalmologist.