One or more limbs can develop uncontrolled muscle contractions that lead to abnormal, fixed postures in a limb or in the neck, which is called dystonia. These issues can be prevented to some degree with stretching exercises and physical and occupational therapy. Dystonia can be treated in some cases using oral medications or with botulinum toxin( Botox) injections into the affected limb. Some people with MSA hold their head bent forward to an extreme degree, a condition called antecollis. This problem may be improved with Botox injected into the neck muscles. Jaw clenching or forced eye closure occur and can also be treated with medication or Botox injections. Botox injections should only be performed by an experienced neurologist to minimize risks and side effects.
Another issue some people experience is sudden, rapid jerks of a limb or of the trunk. This can occur at rest or in reaction to an external stimuli such as a physical touch. This symptom, called myoclonus, is annoying but rarely interferes with normal movement, and it can be treated with medication. MSA can cause a tremor, which is not nearly as prominent as in most people with Parkinson’ s disease. This tremor generally occurs when the limb is in use rather than at rest as in Parkinson’ s disease. It may respond to medication but usually is too mild to require treatment.
Do people with MSA develop dementia? Dementia, or severe memory or cognitive decline, is very unusual in MSA. However, people with MSA may develop milder signs of mental changes, typically after living with the disease for several years. People with MSA can develop difficulty in the aspect of thinking called executive function. This aspect is what allows us to organize information by categories, understand abstractions and instructions, create and follow a plan, and inhibit inappropriate actions and behaviors. Common mental changes that people with MSA may notice include slowed thinking, difficulty with keeping their attention on a task, and difficulty with multitasking. Occasionally, people with MSA may also experience inappropriate or unintentional laughter or crying, a symptom called pseudobulbar affect. These mental changes rarely become functionally limiting for people living with MSA.
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What happens to someone with MSA over time? Unfortunately, MSA is progressive. This means that over time, people with MSA will notice increasing severity of their symptoms and / or onset of new symptoms. Not everyone experiences all of the symptoms of MSA, and the appearance and progression of these symptoms vary greatly among individuals.
Research has shown that someone with MSA lives about eight to ten years after the onset of symptoms, on average. The most common complications in MSA are infections, particularly pneumonia and urinary tract infections. Abnormal breathing, particularly at night, along with severe blood pressure fluctuations, blood clots, and falls are other common and potentially serious complications in MSA. Your doctor may recommend regular examinations of your swallowing function to ensure that food is not entering the lung spaces and causing pneumonia, evaluations by a urologist to test your urinary function, sleep studies to test your nighttime breathing, adaptive