Multiple system atrophy (MSA) is a rare neurodegenerative disorder that affects multiple parts of the body, including the body’s involuntary (autonomic) functions such as blood pressure, digestion, and temperature regulation. Signs of MSA usually begin appearing in a person’s 50s. Some symptoms are similar to those of Parkinson’s disease, but they advance much more rapidly.
Autonomic Symptoms
All people with MSA have autonomic dysfunction, but it varies in severity from person to person. Symptoms can include:
- Cold hands or feet and heat intolerance, because control of body temperature is impaired
- Impotence
- Fainting or lightheadedness when standing, caused by orthostatic hypotension, a condition in which blood pressure drops when a person rises from a seated or prone position
- Less sweat, tears, and saliva
- Sleep disorders, such as sleep apnea or a tendency to act out dreams
- Urinary or bowel dysfunction, such as constipation or incontinence (loss of bladder or bowel control)
Motor Control Symptoms
Movement problems might develop much later than autonomic problems in people with MSA. Depending on which types of motor symptoms are most prominent at the time of diagnosis, MSA can fall into one of two categories:
Parkinsonian (MSA-P) symptoms resemble those of Parkinson’s disease and include:
- Low-volume speech
- Rigidity
- Slow movements
- Slow or shuffling walk leading to falls
- Tremor (usually mild)
Cerebellar ataxia (MSA-C) symptoms resemble those of ataxia (lack of coordination) and include:
- Limb incoordination
- Slurred speech
- Swallowing and chewing difficulty
- Unsteady gait and loss of balance, causing falls
- Visual disturbances, such as blurred or double vision and difficulty focusing the eyes
Other MSA-related symptoms include:
- Dystonia, involuntary muscle contractions that can cause abnormal posture of limbs or the neck
- Vocal cord impairment causing stridor, a harsh, high-pitched sound when breathing
