Symptoms

Multiple system atrophy (MSA) affects many parts of your body. Symptoms typically develop in adulthood, usually in the 50s or 60s.

MSA is classified by two types: parkinsonian and cerebellar. The type depends on the symptoms you have at diagnosis.

Parkinsonian type

This is the most common type of MSA. The signs and symptoms are similar to those of Parkinson's disease, such as:

• Rigid muscles
• Difficulty bending your arms and legs
• Slow movement (bradykinesia)
• Tremors (rare in MSA compared with classic Parkinson's disease)
• Problems with posture and balance

Cerebellar type

The main signs and symptoms are problems with muscle coordination (ataxia), but others may include:

• Impaired movement and coordination, such as unsteady gait and loss of balance
• Slurred, slow or low-volume speech (dysarthria)
• Visual disturbances, such as blurred or double 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 can also develop dangerously high blood pressure levels while lying down (supine hypertension).

MSA might cause other difficulties with involuntary (autonomic) body functions, including:

Urinary and bowel dysfunction

• Constipation
• Loss of bladder or bowel control (incontinence)

Sweating abnormalities

• Reduced production of sweat, tears and saliva
• Heat intolerance due to reduced sweating
• Impaired body temperature control, often causing cold hands or feet

Sleep disorders

• Agitated sleep due to "acting out" dreams
• Abnormal breathing at night

Sexual dysfunction

• Inability to achieve or maintain an erection (impotence)
• Loss of libido

Cardiovascular problems

• Color changes in hands and feet caused by pooling of blood
• Cold hands and feet

Psychiatric problems

• Difficulty controlling emotions, such as laughing or crying inappropriately

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.