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Symptoms
By Mayo Clinic staffMultiple system atrophy is so named because its signs and symptoms affect multiple parts of your body. Previously called Shy-Drager syndrome, MSA is classified by two types: parkinsonian and cerebellar, depending on which types of symptoms predominate at the time of evaluation.
Parkinsonian type
Predominant signs and symptoms are those of Parkinson's disease, such as:
- Rigid muscles and difficulty bending your arms and legs
- Slow movement (bradykinesia)
- Tremors (rare in MSA compared with classic Parkinson's disease)
- Impaired posture and balance
Cerebellar type
Predominant signs and symptoms are lack of muscle coordination (ataxia). Signs and symptoms may include:
- Impairment of movement and coordination, such as unsteady gait and loss of balance
- Slurred, slow or low-volume speech (dysarthria)
- Visual disturbances, such as blurred vision and difficulty focusing your eyes
- Difficulty swallowing (dysphagia) or chewing
General signs and symptoms
In addition, the primary sign of multiple system atrophy is:
- Postural (orthostatic) hypotension, a form of low blood pressure that makes you feel dizzy or lightheaded, or even faint, when you stand up from sitting or lying down.
You also can develop dangerously high blood pressure levels while lying down.
People with multiple system atrophy may have other difficulties with body functions that occur voluntarily (autonomic), including:
- Impotence and loss of libido (in men)
- Loss of bladder or bowel control (incontinence)
- A reduction in the production of perspiration, tears and saliva
- Impaired control of body temperature, often causing cold hands or feet as well as heat intolerance due to impaired sweating
- Constipation
- Irregular heartbeat
- Difficulty controlling emotions
- Agitated sleep due to "acting out" one's dreams
- Abnormal breathing at night
When to see a doctor
If you develop any of the signs and symptoms associated with multiple system atrophy, see your doctor for an evaluation and diagnosis. If you've already been diagnosed with the condition, contact your doctor if new symptoms occur or if existing symptoms worsen.
- Factor SA, et al. Multiple system atrophy: Prognosis and treatment. http://www.uptodate.com/index/home.html. Accessed March 22, 2011.
- Stefanova N, et al. Multiple system atrophy: An update. Lancet Neurology. 2009;8:1172.
- Multiple system atrophy. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec16/ch208/ch208d.html. Accessed April 5, 2011.
- Factor SA, et al. Multiple system atrophy: Clinical features and diagnosis. http://www.uptodate.com/index/home.html. Accessed April 6, 2011.
- NINDS multiple system atrophy information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/msa/msa.htm. Accessed April 5, 2011.
- NINDS multiple system atrophy with orthostatic hypotension information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/msa_orthostatic_hypotension/msa_orthostatic_hypotension.htm. Accessed April 5, 2011
- Gilman S, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology. 2008;71:670.
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