What is Multiple System Atrophy (MSA)?

Multiple system atrophy (MSA) is an uncommon neurodegenerative illness with a variable co-mixture of Parkinsonism (slowness, stiffness, tremors, imbalance), impairment of the cerebellum (incoordination in gait and using hands), and autonomic involvement (postural dizziness, blackouts, urinary urgency/dribbling …)

What are the symptoms of Multiple System Atrophy (MSA)?

The early signs of MSA are usually indistinguishable from the early signs of Parkinson's disease and comprise:

• Slowness of movement, tremor, or stiffness
• Clumsiness or incoordination
• Speech impairment, a croaky, quivering voice
• Fainting or dizziness caused by orthostatic hypotension, a condition where blood pressure falls when standing up from a seated or lying position
• Bladder control impairment, such as an urgent need to urinate or an inability to empty the bladder
• Physicians classify MSA into two distinct forms, based on the most significant symptoms when a person is assessed:
• The Parkinsonian type (MSA-P), with initial symptoms being like Parkinson's disease (e.g., moving slowly, stiffness, tremor), combined with balance, coordination, and autonomic nervous system dysfunction difficulties
• The cerebellar type (MSA-C), with initial symptoms involving ataxia (balance and coordination difficulties), swallowing difficulty, speech disturbance or a quavering voice, and abnormal eye movements ("cerebellar" indicates a region of the brain associated with coordination)
• MSA has a more accelerated progression than Parkinson's disease, and most MSA patients will need an aid to walk, i.e., a cane or walker, a few years following the onset of symptoms.

Some other MSA symptoms are:

• Contractures (ongoing tightening of muscles or tendons about joints, making it impossible for the joints to move freely) in limbs or hands
• Pisa syndrome, a bizarre posture where the body leans toward one side like the leaning tower of Pisa
• Antecollis, where the neck flexes forward and the head hangs down
• Involuntary, uncontrollable sighing or gasping
• Sleep disturbances, including a tendency to behave out of dreams, are known as rapid eye movement (REM) sleep behavior disorder.
• Other individuals with MSA may feel anxious or depressed.

How is Multiple System Atrophy (MSA) diagnosed?

It may be challenging to diagnose Multiple System Atrophy, especially in the initial phases, partly because most of the characteristics are quite comparable to those seen in Parkinson's disease.

Following a clinical history and brief neurological examination, a physician might order several tests to make the diagnosis. These might include autonomic testing (e.g., blood pressure and heart rate regulation), bladder function testing, and/or imaging studies such as an MRI or PET scan. An MRI of the brain may reveal changes that could either point to MSA or rule out other causes of the observed symptoms.

What are the treatments for Multiple System Atrophy?

There are no treatments available to slow the progressive neurodegeneration of MSA, and there is no cure. There are treatments that can help individuals manage the symptoms of MSA.

In certain individuals, levodopa can improve motor function; however, the benefit is not sustained as the disease advances.

The faintness and dizziness due to orthostatic hypotension can often be managed with simple measures, including wearing compression stockings, increasing salt and/or water intake, and avoiding very heavy meals. The medications fludrocortisone and midodrine are occasionally ordered.

Difficulty maintaining bladder control depends on the kind of difficulty involved. Anticholinergic medicines, like oxybutynin or tolteridine, are used to make the sudden necessity to urinate less.

Abnormally fixed muscle postures (dystonia) can be managed with botulinum toxin injections.

Sleep disorders like REM sleep behavior disorder can be managed with medications like clonazepam, melatonin, or certain antidepressants.

Some people with MSA will have serious swallowing trouble and might require a feeding tube or nutrition through a vein. Speech therapy may be of some benefit in determining measures to overcome swallowing challenges.

Physical therapy preserves mobility, reduces contractures (chronic shortening of tendons or muscles surrounding the joints that prevents the joints from moving freely), and lessens muscle spasms and abnormal posture.

Eventually, people may require assistive equipment like walkers and wheelchairs. Occupational therapists ensure home safety and help with activities of daily living, such as dressing and eating.

Why should Multiple System Atrophy be developed?

The etiology of MSA is not known. Most instances are sporadic, that is, they occur unpredictably. A characteristic feature of MSA is the presence of alpha-synuclein protein deposited in glia, the support cells of the brain. Such alpha-synuclein deposits are especially seen in oligodendroglia, cells that produce myelin (a sheath around nerve cells that allows them to transmit electrical signals quickly). This protein also builds up in Parkinson's disease, but within nerve cells. Since they both share a cellular accumulation of alpha-synuclein, MSA and Parkinson's disease are also known as synucleinopathies. One potential risk factor for the disease is changes in the synuclein gene SCNA, which encodes alpha-synuclein.

Can MSA be inherited from one generation to another?

Multiple System Atrophy (MSA) is an idiopathic disorder (meaning it's not inherited).  We don't know much about its effect on a specific subset of individuals or which genes are involved.  But a variety of gene sets are being studied as potential causes.

What is the life expectancy of MSA?

Symptoms are usually seen in a person's 50s and progress quickly over a period of 5 to 10 years, with increasing loss of motor ability and ultimate bed confinement.

Why choose Tender Palm Super Speciality Hospital for Multiple System Atrophy (MSA) treatment in Lucknow, India?

Tender Palm Super Speciality Hospital offers advanced Multiple System Atrophy (MSA) treatment in Lucknow, India, at an affordable cost. We have a team of experienced neurologists, movement disorder specialists, autonomic nervous system experts, and rehabilitation specialists who provide accurate diagnosis, personalized neurological care, and advanced treatment for Multiple System Atrophy. Our neurosciences team has extensive experience in successfully treating Multiple System Atrophy (MSA) in Lucknow, India.

To seek an Expert Consultation for Multiple System Atrophy (MSA) treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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