What is Multiple System Atrophy?
Multiple System Atrophy (MSA) is a rare, progressive neurological disorder, caused by cell loss in certain areas of the brain leading to a variety of symptoms affecting especially the functions of the autonomic nervous system and the motor system.
Depending on the brain areas most predominantly involved, a subset of disorders have been described including sporadic olivopontocerebellar atrophy (sOPCA), which is characterized primarily by disturbances of balance, coordination and speech, striatonigral degeneration (SND), where the patient initially suffers from parkinsonian features like bradykinesia (=slowed movements), rigidity (=stiffness) and tremor, and Shy-Drager syndrome, with marked changes in blood pressure regulation, urinary difficulties and, (in male patients) disturbance of sexual function predominating the initial presentation.
As this variety of names often caused confusion not only among patients, but also physicians, MSA is nowadays referred to as MSA-P type if parkinsonian features predominate or MSA-C type if cerebellar symptoms predominate, replacing the terms SND and sOPCA .The term Shy-Drager syndrome should not be used anymore as almost every patient is affected by autonomic/urinary dysfunction.
MSA affects both man and woman, with an average symptom onset in the 6th decade and a prevalence rate of 3 to 4.4/100.000 / about 4/100.000. The majority of patients diagnosed with MSA do not have a good prognosis with an average survival rate of 9 years following disease onset.
The cause of the cell loss leading to MSA still remains unknown, but there is no evidence for a hereditary component and it is not contagious.