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Alternative Names Return to topShy-Drager syndrome; Neurologic orthostatic hypotension; Shy-McGee-Drager syndrome; Parkinson's plus syndrome
Definition Return to top
Multiple system atrophy (MSA) is a rare condition that causes symptoms similar to Parkinson's disease. However, patients with MSA have more widespread damage to the autonomic nervous system. This is the part of the nervous system that controls important organ functions such as heart rate, blood pressure, digestive system muscles, and sweating.
Causes Return to top
The cause is unknown. MSA develops gradually and is most often diagnosed in men older than 60.
Symptoms Return to top
MSA damages the nervous system, which can cause the following symptoms:
Other symptoms that may occur with this disease:
Exams and Tests Return to top
The health care provider may perform the following:
There are no specific tests to confirm this disease. A neurologist can make the diagnosis based on:
Testing to help confirm the diagnosis may include:
Treatment Return to top
There is no cure for MSA, and there is no known way to prevent the disease from getting worse. The goal of treatment is to control symptoms.
Anticholinergic medications may be used to reduce early or mild tremors. Levodopa may improve movement and balance.
Carbidopa may reduce the side effects of Levodopa and make it work better. However, the response to medications may be disappointing. Many people respond poorly to treatment with anticholinergics or Levodopa.
Medications that may be used to treat low blood pressure include:
A pacemaker that is programmed to stimulate the heart to beat at a rapid rate (faster than 100 beats per minute) may increase blood pressure for some people.
Constipation can be treated with a high-fiber diet and laxatives. Impotence may be treated with drugs that enhance erections.
Outlook (Prognosis) Return to top
The outcome is poor. Loss of mental and physical functions slowly get worse. Early death is likely.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you develop symptoms of this disorder.
Call your health care provider if you have been diagnosed with MSA and your symptoms return or get worse. Also call if new symptoms appear, including possible side effects of medications:
Contact your health care provider if you have a family member with this disorder and his or her condition deteriorates to the point that you are unable to care for the person at home.
References Return to top
Lang A. Parkinsonism. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 433.Update Date: 10/30/2008 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.