DISEASE SUMMARY:
Multiple System Atrophy( MSA)
I have this diagnosis
MSA is an adult-onset, neurological disease that impacts movement, coordination and the autonomic nervous system.
• MSA is a rare neurodegenerative disease affecting multiple brain circuits(“ systems”).
• It is commonly referred to as an“ atypical parkinsonian condition” because of the overlap of certain symptoms with Parkinson’ s disease. Early symptoms can also be similar to cerebellar ataxia. MSA may be originally misdiagnosed as Parkinson’ s disease or cerebellar ataxia because of this.
• Pathologically classified as a synucleinopathy( which is abnormal accumulation of the alpha synuclein protein in the brain, which is also found in Parkinson’ s disease).
• Average age of onset is the mid-50s.
• There are about 2 – 5 cases per 100,000 people. However, this is likely an underestimate given that many people with MSA have not yet been diagnosed or are diagnosed with something else.
• Slightly more common in men.
> TIP: Cross out the two pages of the other diseases that do not apply( e. g.,
if the person has MSA, cross out the CBD and PSP pages)
• Subclassified into two types, both of which include elements of the others:
• MSA-P( Parkinsonian): more prominent symptoms of slow and small movements, rigidity, tremor and shuffling gait.
• MSA-C( cerebellar): more pronounced difficulty with balance and coordination.
• In the past, there was a third sub-type, called Shy- Drager syndrome, that primarily referred to those with pronounced autonomic dysfunction. Use of this name is no longer common, but may sometimes be used to reference MSA.
• Life expectancy averages eight to ten years after symptom onset, with a wide range.
• No known way to reverse or stop the progression, though many symptoms can be managed with medication, rehabilitation therapies and close monitoring of safety and functioning.
SIGNS AND SYMPTOMS
> Limited response to levodopa therapy
> Faster progression, especially compared to Parkinson’ s disease
> Early postural instability and falls
> Clumsy, shuffling, frozen or uncoordinated gait
> Difficulty with controling and coordinating movements( ataxia)
> Rapid, isolated jerks that can occur anywhere in the body( myoclonus)
> Parkinsonian symptoms( rigidity, slowness, tremor)
> Significant fluctuations in blood pressure( orthostatic hypotension)
> Erectile dysfunction
> Urinary dysfunction: urgency, frequency, incontinence, retention
> Constipation
> Slurred or softer speech which tend to emerge earlier and more significantly than seen in Parkinson’ s
> Swallowing difficulty, including coughing / choking on solids or liquids
> REM behavioral disorder( RBD)— acting out dreams while sleeping
> Breathing irregularities including sudden large breaths( inspiratory stridor) or cessation of breathing while sleeping( apnea)
> Cognitive impairment is uncommon with MSA, although some can have mild changes to executive function( multitasking, planning, attention, organization)
> Depression, anxiety and apathy
Refer to the MSA: Some Answers for detailed information on the diagnosis. www. curepsp. org / iwanttolearn
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