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Tests and diagnosis
By Mayo Clinic staffDiagnosis of multiple system atrophy can be challenging because there's no test that can make or confirm the diagnosis. At the same time, certain signs and symptoms of MSA — such as muscle rigidity and unsteady gait — also occur with other disorders, such as Parkinson's disease, making the diagnosis more difficult. As a result, some people are never properly diagnosed, although doctors are increasingly aware of the disease and thus more likely to identify its symptoms.
If your doctor suspects multiple system atrophy, he or she will obtain a medical history and perform a physical examination. You may receive a referral to a neurologist or other specialist for specific evaluations that can help in making the diagnosis.
Tilt table test
One procedure that can aid in the diagnostic process is a tilt table test to help determine if you have a problem with blood pressure control. In this procedure, you're placed on a motorized table and strapped in place. Then the table is tilted upward so that your body is nearly vertical.
Throughout this maneuver, your blood pressure and heart rate are monitored. The findings can document not only the extent of blood pressure irregularities, but also whether they occur with a change in physical position.
Other tests
At times, doctors may order certain other tests to help establish a disorder or rule out the presence of other conditions. These other tests may include:
- Blood tests
- A sweat test to evaluate perspiration
- Tests to assess your bladder and bowel function
- Electrocardiogram to track the electrical signals of your heart
- Brain-imaging tests, particularly a magnetic resonance imaging (MRI) scan, to determine whether brain lesions are present that may be triggering symptoms
If you have sleep irregularities, particularly if they involve interrupted breathing or snoring, your doctor may recommend having you evaluated in a sleep laboratory to determine if you have an underlying and treatable sleep disorder, such as sleep apnea.
- Santamaria J, et al. Multiple system atrophy and sleep. Sleep Medicine Clinics. 2008;3:337.
- Wein AJ. Lower urinary tract dysfunction in neurologic injury and disease. In: Wein AJ, et al., eds. Wein: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/137596783-5/841660509/1445/62.html#4-u1.0-B978-0-7216-0798-6..50061-3_4358. Accessed May 14, 2009.
- Siddique N, et al. Degenerative neuropathies. In: Goetz GG. Textbook of Clinical Neurology. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/137596783-6/0/1488/307.html?tocnode=53803248&fromURL=307.html#4-u1.0-B978-1-4160-3618-0..10036-0_2717. Accessed May 14, 2009.
- Gilman S, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology. 2008;71:670.
- Saper CB. Autonomic disorders and their management. In: Goldman L, et al., eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/137596783-7/841660962/1492/1482.html#4-u1.0-B978-1-4160-2805-5..50450-X_18987. Accessed May 14, 2009.
- Bhidayasiri R, et al. Multiple system atrophy. The Neurologist. 2008;14:224.
- Low PA, et al. Management of neurogenic orthostatic hypotension: An update. The Lancet Neurology. 2008;7:451.
- 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 May 14, 2009.
