Multiple System Atrophy


Multiple system atrophy (MSA) is a disorder of the nervous system.

MSA is sometimes called a Parkinson plus syndrome because many of the symptoms are similar. There are different types MSA based on symptoms. Once symptoms develop, the average life expectancy is 10 years or less.


The cause of MSA is unknown. Genetic factors may play a role in some families.

The symptoms are caused by degeneration of nerves throughout the brain and spinal cord. These nerves control automatic functions like balance and muscle coordination. The damage to the nerve may be caused by a buildup of a specific protein, but this is not a confirmed cause.

Nervous System
Copyright © Nucleus Medical Media, Inc.

Risk Factors

MSA tends to appear after 60 years of age.


Symptoms of MSA can vary greatly. Initial symptoms are similar to those of Parkinson's disease. These initial symptoms may also be determined by the type of MSA:

  • Type MSA-A is associated with orthostatic hypotension. This is where blood pressure drops when moving from sitting to standing. It can lead to lightheadedness or fainting.
  • Type MSA-P is associated with symptoms similar to initial Parkinson's symptoms such as:
    • Slow, stiff movements
    • Tremors
    • Clumsiness—loss of balance and coordination
    • Shuffling
  • Type MSA-C is associated with:
    • Difficulty swallowing
    • Problems speaking and hoarseness
    • Trouble breathing due to tightness in throat
    • Difficulty coordinating muscle movement

As the disease progresses, symptoms will cross over types and become more severe. Many will develop muscle coordination problems and need walking aids. Other problems that may exist across type include:

  • Problems with bladder and bowel control
  • Erectile dysfunction
  • Muscle tightening around a joint that prevents free movement
  • Problems with posture, such as leaning to one side and forward head bend
  • Trouble with sweating
  • Inappropriate laughing or crying
  • Excess yawning
  • Vision problems
  • Changes in writing


You will be asked about your symptoms and medical history. An exam of the nervous system will also be done. You will likely be referred to a specialist.

Tests may include:

  • Blood tests
  • Testing of owel and bladder function

Images may be taken of your bodily structures. This can be done with an MRI scan .

Tests will also be done on your heart rate and blood pressure. These tests will help determine what is causing problems with your autonomic nervous system. Nerve impulses to your muscles may also be tested.


There is no cure for MSA. Treatment will focus on managing the symptoms and supportive care. Talk with your doctor about the best plan for you. Options include the following:


Various medications may be used to manage the symptoms of MSA. Medication may be given to:

  • Relieve muscle rigidity
  • Stabilize mood
  • Manage orthostatic hypotension
  • Relieve other symptoms such as constipation, urinary control problems, or erectile dysfunction


  • Physical therapy—to help keep muscles strong and maintain range of motion
  • Occupational therapy—to improve ability to do daily tasks such as eating, grooming, and dressing
  • Speech therapy—to help with speaking and swallowing
  • Respiratory therapy—Continuous positive airway pressure (CPAP) for sleep apnea and other breathing problems during sleep

Dietary Support

Dietary changes in salt and fluids may help manage orthostatic hypotension.

Soft or pureed foods may be helpful with swallowing problems.

A feeding tube may be needed in later stages of MSA. It will deliver nutrition directly to the stomach.


There are no known guidelines to prevent MSA since the cause is not clear.


  • EBSCO Medical Review Board Rimus Lukas, MD
  • Reviewed: 11/2017
  • Updated: 01/20/2015

Please note, not all procedures included in this resource library are available at Henry Ford Allegiance Health or performed by Henry Ford Allegiance Health physicians.

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Editorial Policy | Privacy Policy | Terms and Conditions | Support
Copyright © 2008 EBSCO Publishing. All rights reserved.

Colon cancer screens can prevent colon cancer by finding and removing growths before they turn into cancer. Screens also find colon cancer early, while it’s easiest to treat.