Multiple System Atrophy

What is Multiple System Atrophy?

Multiple System Atrophy (MSA) is a progressive neurological disorder caused by degeneration of nerve cells in three main areas of the brain: the basal ganglia, the cerebellum and the brain stem.  This cell loss results in a variety of problems - in particular with movement, balance and other autonomic functions of the body - which are very similar to Parkinson’s.

Depending on the part of the brain in which the nerve cell degeneration occurs the symptoms produced will vary and not everyone will experience them all.  Some of the most common symptoms include:

• slowed movements
• rigidity or stiffness
• difficulty turning in bed
• start hesitation, or difficulty in initiating a movement
• difficulty writing; writing may become small and spidery
• loss of balance and poor coordination or clumsiness (ataxia)
• speech difficulties
• difficulty with fine motor skills such as doing up buttons
• problems with erection or male impotence
• loss of bladder control, including urgency, frequent urination or incomplete emptying
• bowel problems, including constipation
•  inability to sweat
• cold hands and feet
•  drop in blood pressure when standing (orthostatic hypotension), leading to dizziness, fainting or blurred vision
•  ‘coat hanger pain’  (pain in neck or shoulders) as a result of low blood pressure
• problems with swallowing
• nightmares or hallucinations
• heightened emotions
• depression, anxiety or a feeling of being unable to cope
• soft voice
• restless sleep

• noisy breathing, including snoring when sleeping.

   

Once thought to be a rare disorder because it regularly went undiagnosed, it is now believed that MSA affects approximately five in every 100,000 people in the UK.  It occurs in both men and women, with onset usually between the ages of 50 and 60 years, although it can also affect older or younger people. 

• Samantha Pavey, The Multiple System Atrophy Trust, London, UK