BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuMultiple system atrophy - parkinsonian typeShy-Drager syndrome; Neurologic orthostatic hypotension; Shy-McGee-Drager syndrome; Parkinson plus syndrome; MSA-P; MSA-CMultiple system atrophy- parkinsonian type (MSA-P) is a rare condition that causes symptoms similar to Parkinson disease. However, people with MSA-P have more widespread damage to the part of the nervous system that controls important functions such as heart rate, blood pressure, and sweating.Parkinson diseaseParkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking (tremors...ImageRead Article Now Book Mark Article The other subtype of MSA is MSA-cerebellar. It mainly affects the cerebellum, an area deep in the brain, just above the spinal cord.MSA-cerebellarMultiple system atrophy - cerebellar subtype (MSA-C) is a rare disease that causes areas deep in the brain, just above the spinal cord, to shrink (at...ImageRead Article Now Book Mark Article Causes The cause of MSA-P is unknown. The affected areas of the brain overlap with areas affected by Parkinson disease, with similar symptoms. For this reason, this subtype of MSA is called parkinsonian. MSA-P is most often diagnosed in men older than 60. Symptoms MSA damages the nervous system. The disease tends to progress rapidly. About one half of people with MSA-P have lost most of their motor skills within 5 years of onset of the disease.Symptoms may include:Tremors Movement difficulties, such as slowness, loss of balance, shuffling when walking Frequent falls Muscle aches and pains (myalgia), and stiffness Face changes, such as a masklike appearance to the face and staring Difficulty chewing or swallowing (occasionally), not able to close the mouth Disrupted sleep patterns (often during rapid eye movement [REM] sleep late at night) Dizziness or fainting when standing up or after standing still Erection problems Erection problemsAn erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...ImageRead Article Now Book Mark Article Loss of control over bowels or bladder Problems with activity that requires small movements (loss of fine motor skills), such as writing that is small and hard to read Loss of sweating in any part of the body Decline in mental function Nausea and problems with digestion Posture problems, such as unstable, stooped, or slumped over Vision changes, decreased or blurred vision Vision changesThere are many types of eye problems and vision disturbances, such as: Halos Blurred vision (the loss of sharpness of vision and the inability to see...ImageRead Article Now Book Mark Article Voice and speech changes Other symptoms that may occur with this disease:Confusion ConfusionConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Dementia DementiaDementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...ImageRead Article Now Book Mark Article Depression DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...ImageRead Article Now Book Mark Article Sleep-related breathing difficulties, including sleep apnea or a blockage in the air passage that leads to a harsh vibrating sound Sleep apneaObstructive sleep apnea (OSA) is a problem in which your breathing pauses during sleep. This occurs because of narrowed or blocked airways.ImageRead Article Now Book Mark Article Restless legs Exams and Tests Your health care provider will examine you, and check your eyes, nerves, and muscles. Your blood pressure will be taken while you are lying down and standing up. There are no specific tests to confirm this disease. A doctor who specializes in the nervous system (neurologist) can make the diagnosis based on:History of symptoms Physical examination results Ruling out other causes of symptoms Testing to help confirm the diagnosis may include:MRI of head MRI of headA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Plasma norepinephrine levels NorepinephrineThis test measures the levels of catecholamines in the blood. Catecholamines are hormones made by the adrenal glands. The three catecholamines are ...ImageRead Article Now Book Mark Article Urine examination for norepinephrine breakdown products (urine catecholamines) Urine catecholaminesCatecholamines are chemicals made by nerve tissue (including the brain) and the adrenal gland. The main types of catecholamines are dopamine, norepin...ImageRead Article Now Book Mark Article Treatment There is no cure for MSA-P. There is no known way to prevent the disease from getting worse. The goal of treatment is to control symptoms.Dopaminergic medicines, such as levodopa and carbidopa, may be used to reduce early or mild tremors. But, for many people with MSA-P, these medicines do not work well. Medicines may be used to treat low blood pressure.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.PacemakerA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Constipation can be treated with a high-fiber diet and laxatives. Medicines are available to treat erection problems. Support Groups More information and support for people with MSA-P and their families can be found at:National Organization for Rare Disorders -- rarediseases.org/rare-diseases/multiple-system-atrophy The MSA Coalition -- www.multiplesystematrophy.org/msa-resources/ Outlook (Prognosis) Outcome for MSA is poor. Loss of mental and physical functions slowly get worse. Early death is likely. People typically live 7 to 9 years after diagnosis. When to Contact a Medical Professional Contact your provider if you develop symptoms of this disorder.Contact your provider if you have been diagnosed with MSA and your symptoms return or get worse. Also contact your provider if new symptoms appear, including possible side effects of medicines, such as:Changes in alertness/behavior/mood Delusional behavior Dizziness Hallucinations HallucinationsHallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.Read Article Now Book Mark Article Involuntary movements Loss of mental functioning Nausea or vomiting Severe confusion or disorientation If you have a family member with MSA and their condition declines to the point that you are unable to care for the person at home, seek advice from your family member's provider.Open ReferencesReferencesJankovic J. Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 96.Romero-Ortuno R, Wilson KJ, Hampton JL. Disorders of the autonomic nervous system. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 63.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationA Closer Look Alzheimer disease - InDepth(In-Depth)Related Information Parkinson disease(Condition)Parkinson disease - InDepth(In-Depth) Review Date: 11/2/2022 Reviewed By: Evelyn O. Berman, MD, Assistant Professor of Neurology and Pediatrics at University of Rochester, Rochester, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 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Multiple system atrophy - parkinsonian typeShy-Drager syndrome; Neurologic orthostatic hypotension; Shy-McGee-Drager syndrome; Parkinson plus syndrome; MSA-P; MSA-CMultiple system atrophy- parkinsonian type (MSA-P) is a rare condition that causes symptoms similar to Parkinson disease. However, people with MSA-P have more widespread damage to the part of the nervous system that controls important functions such as heart rate, blood pressure, and sweating.Parkinson diseaseParkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking (tremors...ImageRead Article Now Book Mark Article The other subtype of MSA is MSA-cerebellar. It mainly affects the cerebellum, an area deep in the brain, just above the spinal cord.MSA-cerebellarMultiple system atrophy - cerebellar subtype (MSA-C) is a rare disease that causes areas deep in the brain, just above the spinal cord, to shrink (at...ImageRead Article Now Book Mark Article Causes The cause of MSA-P is unknown. The affected areas of the brain overlap with areas affected by Parkinson disease, with similar symptoms. For this reason, this subtype of MSA is called parkinsonian. MSA-P is most often diagnosed in men older than 60. Symptoms MSA damages the nervous system. The disease tends to progress rapidly. About one half of people with MSA-P have lost most of their motor skills within 5 years of onset of the disease.Symptoms may include:Tremors Movement difficulties, such as slowness, loss of balance, shuffling when walking Frequent falls Muscle aches and pains (myalgia), and stiffness Face changes, such as a masklike appearance to the face and staring Difficulty chewing or swallowing (occasionally), not able to close the mouth Disrupted sleep patterns (often during rapid eye movement [REM] sleep late at night) Dizziness or fainting when standing up or after standing still Erection problems Erection problemsAn erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...ImageRead Article Now Book Mark Article Loss of control over bowels or bladder Problems with activity that requires small movements (loss of fine motor skills), such as writing that is small and hard to read Loss of sweating in any part of the body Decline in mental function Nausea and problems with digestion Posture problems, such as unstable, stooped, or slumped over Vision changes, decreased or blurred vision Vision changesThere are many types of eye problems and vision disturbances, such as: Halos Blurred vision (the loss of sharpness of vision and the inability to see...ImageRead Article Now Book Mark Article Voice and speech changes Other symptoms that may occur with this disease:Confusion ConfusionConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Dementia DementiaDementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...ImageRead Article Now Book Mark Article Depression DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...ImageRead Article Now Book Mark Article Sleep-related breathing difficulties, including sleep apnea or a blockage in the air passage that leads to a harsh vibrating sound Sleep apneaObstructive sleep apnea (OSA) is a problem in which your breathing pauses during sleep. This occurs because of narrowed or blocked airways.ImageRead Article Now Book Mark Article Restless legs Exams and Tests Your health care provider will examine you, and check your eyes, nerves, and muscles. Your blood pressure will be taken while you are lying down and standing up. There are no specific tests to confirm this disease. A doctor who specializes in the nervous system (neurologist) can make the diagnosis based on:History of symptoms Physical examination results Ruling out other causes of symptoms Testing to help confirm the diagnosis may include:MRI of head MRI of headA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Plasma norepinephrine levels NorepinephrineThis test measures the levels of catecholamines in the blood. Catecholamines are hormones made by the adrenal glands. The three catecholamines are ...ImageRead Article Now Book Mark Article Urine examination for norepinephrine breakdown products (urine catecholamines) Urine catecholaminesCatecholamines are chemicals made by nerve tissue (including the brain) and the adrenal gland. The main types of catecholamines are dopamine, norepin...ImageRead Article Now Book Mark Article Treatment There is no cure for MSA-P. There is no known way to prevent the disease from getting worse. The goal of treatment is to control symptoms.Dopaminergic medicines, such as levodopa and carbidopa, may be used to reduce early or mild tremors. But, for many people with MSA-P, these medicines do not work well. Medicines may be used to treat low blood pressure.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.PacemakerA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Constipation can be treated with a high-fiber diet and laxatives. Medicines are available to treat erection problems. Support Groups More information and support for people with MSA-P and their families can be found at:National Organization for Rare Disorders -- rarediseases.org/rare-diseases/multiple-system-atrophy The MSA Coalition -- www.multiplesystematrophy.org/msa-resources/ Outlook (Prognosis) Outcome for MSA is poor. Loss of mental and physical functions slowly get worse. Early death is likely. People typically live 7 to 9 years after diagnosis. When to Contact a Medical Professional Contact your provider if you develop symptoms of this disorder.Contact your provider if you have been diagnosed with MSA and your symptoms return or get worse. Also contact your provider if new symptoms appear, including possible side effects of medicines, such as:Changes in alertness/behavior/mood Delusional behavior Dizziness Hallucinations HallucinationsHallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.Read Article Now Book Mark Article Involuntary movements Loss of mental functioning Nausea or vomiting Severe confusion or disorientation If you have a family member with MSA and their condition declines to the point that you are unable to care for the person at home, seek advice from your family member's provider.Open ReferencesReferencesJankovic J. Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 96.Romero-Ortuno R, Wilson KJ, Hampton JL. Disorders of the autonomic nervous system. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 63.