What is MSA? [Multiple Systems Atrophy meaning]

Diseases which look like Parkinson’s disease, but have additional features are called “Parkinson’s Plus” syndromes.

You can read more about Parkinson’s Plus Syndromes here.

Multiple System atrophy (MSA) is a Parkinson’s Plus syndrome.

In MSA, a component of our nervous system called the “Autonomic Nervous System” is also affected. This causes problems in body functions such as urination, maintaining blood pressure & cardiac rhythm.

What does the Autonomic Nervous System do?

The Autonomic Nervous System helps us do things that we don’t think about consciously. Thus, it helps us in:

  • Preventing a drop in blood pressure when we stand up from a chair or bed.
    BloodPressure
    The Autonomic Nervous System helps us maintain our Blood Pressure.
  • Maintaining heart rhythm
  • Having an erection
  • Sweating
  • Passing urine and stool

The following symptoms can be seen because of this system dysfunction:

  • A sudden drop in blood pressure can cause sudden dizziness, blurred vision, or loss of consciousness if you stand up abruptly.
    LosingConciousness
    In MSA, patients may feel lightheaded, have blurred visions, or experience loss of consciousness if they stand up suddenly.
  • Heart rhythm problems (these are uncommon).
  • Impotence
  • Reduced sweating
  • Loss of bladder or bowel control or severe constipation

Occasionally, trouble breathing or stridor may be seen. This is a significant problem. Stridor needs to be detected and treated immediately, especially if it occurs in sleep.

Types of MSA

There are 2 types of MSA.

The two types are MSA-P and MSA-C. Both types have the autonomic symptoms described above.

Here are the other differences between the two:

MSA-PMSA-C
More commonLess common
The P stands for ParkinsonismThe C stands for Cerebellum. This brain part helps with balance and coordination.
The 4 cardinal features of Parkinsonism are seen.

These are – slowness, tremor, stiffness & instability.

Out of these, slowness (also called bradykinesia) is most common in MSA-P

These patients appear uncoordinated and unsteady. This is called ATAXIA.

When they are walking, they are unsteady. Therefore they may sway from side-to-side. Onlookers may mistakenly think that they are drunk.

Coordination problems may make it difficult to drink water, write or button shirts.

Swallowing trouble is common.Swallowing trouble appears a bit later.

In the early stages, MSA-P is often misdiagnosed as Parkinson’s disease.

In the early stages, MSA-C patients may have a lot of investigations. This is because many diseases can cause similar symptoms. Click here to know more [External link: Practical Neurology – Khemani 2013].

Later, the autonomic symptoms (described above) become easily noticeable. So, in later stages the diagnosis of MSA becomes easier.

What Causes Multiple System Atrophy (MSA)?

MSA is caused by the accumulation of the same waste material as in Parkinson’s disease (synuclein).

We don’t know why the accumulation of synuclein causes Parkinson’s disease in some and Multiple System Atrophy in others.

What is the Treatment of Multiple System Atrophy (MSA)?

Like all Parkinson’s Plus syndromes, the mainstay treatment is Levodopa. As noted before, the patient’s response to Levodopa is unpredictable and sometimes may not be excellent.

Just like all Parkinson’s Plus syndromes, and Parkinson’s disease itself, many MSA symptoms are treatable. For example:

  • Drop in blood pressure: Maintaining a proper fluid balance and taking medications such as pyridostigmine, fludrocortisone, midodrine may be helpful.
  • Heart rhythm problems: We can control these with medications. In rare cases, a pacemaker may be needed.
    Pacemaker
    Very rarely, a pacemaker may be needed to make sure the heart beats regularly.
  • Impotence: There are many effective medications for impotence.
  • Bladder & bowel control: A mixture of behavioural changes, physical supports (diapers), and medications are usually helpful.
  • Stridor: Patients with stridor may need further evaluation with a sleep study. If there are severe breathing problems while sleeping, then a machine called CPAP can be used to keep the airway open.
    For critical problems, putting a small tube in the windpipe (tracheostomy) may be considered.

Click here to know more about Stridor in MSA [External Link: Cortelli 2019 in the journal Neurology].

 

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

Send Message


NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

4.7 57 reviews

  • Avatar JAIKUMAR MANI ★★★★★ in the last week
    My experience with Dr Siddharth Kharkar was really awesome. It’s always great to be in the presence of someone who is a renowned expert in his field & … More it brings peace of mind that the advice will obviously be the correct one. In addition, his ability to convey complex workings of the human brain in such simple terms that a layman like me could easily understand was something I really appreciated. I heartily Thank Dr Kharkar for his astute advice & gladly recommend him to anyone who needs a neurologist.
  • Avatar Rohit shetye ★★★★★ 3 weeks ago
    Best Dr. we have ever meet. Dr. Listened to us patiently and gave us the proper solution. No unnecessary test or didn’t frighten us. Thank you so much … More Dr.
  • Avatar Ashish Patil ★★★★★ 4 weeks ago
    Great doctor!! Really appreciate.The doctor diagnosed me correctly and start treatment that will help me a lots to improve my condition. The doctor is … More really good, calm and his nature is down to earth, gives confidence to patient!!! Thank you!!!
  • Avatar Bianca D'silva ★★★★★ in the last week
    We had been looking for a specialist in parkinsons for a while now, for my father and when we found Dr. Siddharth Kharka's details on Google, we were … More partly relieved. Partly because, we were all very anxious not knowing how would our visit turn out. I appreciate Dr. Kharkar and his team. He was very clear in his explanations, his knowledge about parkinsons. He took the time to answer the questions we had, went over the diagnosis and started necessary treatment immediately. The only drawback we experienced was the waiting time. Overall, we left the clinic satisfied, knowing much more than when we walked in. We would highly recommend him to anyone looking for a specialist.
  • Avatar Neelam Satghare ★★★★★ 4 weeks ago
    I have visited the doctor clinic for the first timeBut he gave good advice and helped me overcomeMy doubts and queries. It was a good experience.I am very … More thankful for cooperation.
  • Avatar Nitin Ghotge ★★★★★ 4 weeks ago
    Dr.Sidharth Kharkar is one of the best neurologist i came across ....He is really genuine and focused .....We really satisfied after consultancy...
  • Avatar Krishna kumari Radhakrishnan ★★★★★ 2 months ago
    Hi Sharing my experience with Dr KharkarI had consulted with dr regarding my husband’sProblems of tremors. Dr immediately diagnosed on video consultation … More and could help him to control the tremors s of Parkinson’s disease.I found him genuinely polite and free to talk n patiently listening to the patients problem.Now my husband regained his balance n tremors controlled. Many many thanks to Dr Kharkar
  • Avatar a kumar ★★★★★ a month ago
    Dr kharkar is very nice doctor, sir explained each and every thing very nicely, and i am thankful for Dr kharkar for his treatment .
  • Avatar Nidhi Sonawane ★★★★★ 3 months ago
    I had a positive experience with the doctor. He was very sympathetic. His communication skills were good and listened with patience.
  • Avatar Ujwala Sawant ★★★★★ a month ago
    Because of Dr.kharkar sir my husband got new life. Tnx sir.
  • Avatar Mythili Balasubramanian ★★★★★ 4 months ago
    Consultation with the doctor was a very satisfying experience. Was empathetic in his approach, and responded positively to all the queries we had. Thank … More you doctor!
  • Avatar Govind Patel ★★★★★ 2 months ago
    Doctor explained very Good nice person give length time to check body
  • Avatar Sharmila Kumawat ★★★★★ 6 months ago
    Dr Siddharth is one of the best Dr I have ever met. He is kind, polite, helpful and very selfless person. I have migraine and I am his patient since more … More than 2 years. The staff is always helpful and Dr Siddharth is just beyond words for me. Thank you for ur selfless service and kindness u give to all ur patients.

Leave a Comment

India Today Magazine - 2021Noted as one of the Best Neurologists in Mumbai