March is Multiple System Atrophy (MSA) Awareness Month. MSA

March is Multiple System Atrophy (MSA) Awareness Month. MSA is a progressive neurodegenerative disorder characterized by a combination of symptoms that affect both the autonomic nervous system and movement. The symptoms reflect the progressive loss of function of different types of nerve cells in the brain and spinal cord.

Symptoms of autonomic failure that may be seen in MSA include fainting spells and problems with heart rate and bladder control. Motor impairments may include tremor, rigidity, and/or loss of muscle coordination as well as difficulties with speech and walking. Some of these features are similar to those seen in Parkinson’s disease, and early in the disease course it often may be difficult to distinguish these disorders.

MSA is a rare disease, affecting potentially 15,000 to 50,000 Americans. Symptoms tend to appear in a person’s 50s and advance rapidly over the course of 5 to 10 years, with progressive loss of motor function. While some of the symptoms of MSA can be treated with medications, currently there are no drugs that are able to slow disease progression and there is no cure.

The initial symptoms of MSA are often difficult to distinguish from the initial symptoms of Parkinson’s disease and include:

slowness of movement, tremor, or rigidity (stiffness)

clumsiness or incoordination

impaired speech, a croaky, quivering voice

fainting or lightheadedness due to orthostatic hypotension, a condition in which blood pressure drops when rising from a seated or lying down position

bladder control problems, such as a sudden urge to urinate or difficulty emptying the bladder

Doctors divide MSA into two different types, depending on the most prominent symptoms at the time an individual is evaluated:

the parkinsonian type (MSA-P), with primary characteristics similar to Parkinson’s disease (such as moving slowly, stiffness, and tremor) along with problems of balance, coordination, and autonomic nervous system dysfunction

the cerebellar type (MSA-C), with primary symptoms featuring ataxia (problems with balance and coordination), difficulty swallowing, speech abnormalities or a quavering voice, and abnormal eye movements (“cerebellar” reflects a part of the brain involved with coordination)

MSA tends to progress more rapidly than Parkinson’s disease, and most people with MSA will require an aid for walking, such as a cane or walker, within a few years after symptoms begin.

The cause of MSA is unknown. The vast majority of cases are sporadic, meaning they occur at random. Making a diagnosis of MSA can be difficult, particularly in the early stages, in part because many of the features are similar to those observed in Parkinson’s disease.

Speech therapy can benefit individuals with breathing difficulties, slurred speech, decreased vocal power and difficulty swallowing. Our Speech-Language Pathologists have specialized training in the SPEAK OUT! ® speech therapy program, which strengthens the muscles involved in speech and swallowing specifically for individuals with neurological disorders such as Parkinson’s, Essential Tremor, Lewy Body Dementia, Progressive Supranuclear Palsy and Multiple System Atrophy.

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