Multiple system atrophy (MSA)
Multiple system atrophy (MSA) is a neurological condition that affects adults. It's caused by the degeneration (damage) or atrophy (shrinking) of nerve cells in different parts of the brain.
Symptoms of multiple system atrophy
Everyone with MSA will experience different symptoms. Symptoms often start between the ages of 50 and 60, but they can begin anytime from the age of 30.
You're likely to experience muscle control or balance problems, like those of Parkinson's disease or Ataxia. It's a progressive disease which means symptoms will worsen over a period of time.
MSA can cause symptoms including:
- bladder problems like a constant need to pee, loss of bladder control (urinary incontinence) or being unable to pee
- low blood pressure when standing up which might cause dizziness or fainting (postural hypotension)
- erection problems like erectile dysfunction
- problems with co-ordination, balance and speech (cerebellar ataxia)
- tremor, slowness and muscle stiffness
- constipation
Someone with MSA might also have:
- uncontrollable laughing or crying
- problems with sleep like insomnia, restless legs or nightmares
- noisy breathing
- unintentional sighing
- weak, quiet voice
- shoulder and neck pain
- problems controlling sweating
- swallowing problems including difficult chewing and choking episodes
- blurred vision
- cold hands and feet
Causes of multiple system atrophy
The cause of MSA is not clear. It's not thought to be inherited.
Having MSA appears to be random. It's not because of something the person with MSA has done. It has no connection to multiple sclerosis (MS).
There's ongoing research into the possible causes of MSA.
Diagnosing multiple system atrophy
There are many neurological conditions that look similar in the early stages. It might take some time to get a diagnosis of MSA.
There isn't a specific test for MSA. Your doctor will look at your symptoms and rule out other conditions, like Parkinson's disease.
It's more likely you have MSA if:
- your symptoms have progressed quickly
- you've had falls in the early stages of the condition
- you don't respond well to the medicine levodopa
- your speech has been severely affected
- you gasp and breathe noisily
If your doctor thinks you might have MSA, they'll test your reflexes and bodily functions like bladder control and blood pressure.
You might have a brain scan, like an MRI scan, to detect if there's been a loss of brain cells.
Treating multiple system atrophy
There isn't a cure for MSA and there isn't a way of slowing its progress.
As symptoms worsen, you might need help managing day to day life.
Visit the MSA Trust website for information and support about living with MSA. They have a dedicated MSA charity nurses who can help to support you.
Treatment of MSA involves a combination of medication, specialist equipment and the involvement of therapists to manage specific symptoms. It might take time to find the right combination of treatments which work best for you.
Palliative care
You can choose to have palliative care at any stage of MSA in addition to other treatments.
The aim of palliative care is to relieve pain and other symptoms alongside psychological, spiritual and social support.
You might receive palliative care:
- at home
- in a hospice or care home
- as an outpatient in a hospital
- in a hospital
Advance care planning
You might want to consider making plans for the future to help your family and health professionals plan your medical care.
This will be useful if you're unable to communicate later on because you're too ill.
You don't have to make these plans if you don't want to.
Source: Scottish Government
Last updated:
16 June 2023