Meyahealth
HomeGeneticsConditionMultiple system atrophy
Back to Condition
Multiple system atrophy
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Multiple system atrophy

Multiple system atrophy is a progressive, complex brain disorder that impairs movement, balance, and the autonomic nervous system.

Overview

Multiple system atrophy (MSA) is a progressive disorder that disrupts the autonomic nervous system—which controls involuntary functions like blood pressure—and affects movement and balance. Symptoms typically appear around age 55, and the condition worsens over time, with an average survival of 10 years after symptom onset.

Types and Symptoms

There are two major types of MSA, distinguished by the predominant symptoms at diagnosis:

  • MSA-P (Parkinsonian type): Characterized by parkinsonism, including unusually slow movement (bradykinesia), muscle rigidity, tremors, and postural instability.
  • MSA-C (Cerebellar type): Characterized by cerebellar ataxia, which causes problems with coordination and balance, speech difficulties (dysarthria), and impaired eye movement control.

Common autonomic symptoms include a sudden drop in blood pressure upon standing (orthostatic hypotension), urinary difficulties, and erectile dysfunction in men.

Causes

MSA is a complex condition likely resulting from the interaction of genetic, environmental, and lifestyle factors. A hallmark of the disease is the accumulation of clumps of abnormal alpha-synuclein protein (known as inclusions) in the brain and spinal cord, which damage cells controlling movement and autonomic function.

  • Genetic factors: Variants in the SNCA gene (associated with risk in European populations) and the COQ2 gene (associated with risk in Japanese populations) are being studied.
  • Environmental factors: While exposure to solvents or certain toxins has been investigated, these associations remain unconfirmed.

Inheritance

Most cases of multiple system atrophy are sporadic, meaning they occur in individuals with no family history of the disorder. It rarely runs in families and does not follow a clear pattern of inheritance.

Frequently Asked Questions

While both conditions involve parkinsonian symptoms like slowness and rigidity, MSA typically has a more rapid progression and poor response to levodopa (the standard Parkinson's medication). A key differentiator is the early and severe involvement of the autonomic nervous system, particularly orthostatic hypotension (dizziness upon standing) and urinary incontinence, which are less common or occur later in Parkinson's disease. Additionally, MSA-C presents with prominent balance and coordination issues (ataxia) that are not typical of Parkinson's.
The average survival after symptom onset is approximately 10 years, though this varies. The disease is progressive and leads to severe disability, including immobility, difficulty swallowing (dysphagia), and respiratory complications. End-of-life care focuses on managing symptoms like pain, anxiety, and respiratory distress. Advance care planning is crucial early in the diagnosis to discuss preferences regarding life-sustaining treatments, such as feeding tubes or mechanical ventilation, as the disease eventually compromises the ability to communicate and make decisions.
The most significant daily risk is orthostatic hypotension, which can cause sudden drops in blood pressure when standing, leading to fainting and falls. Management includes rising slowly from sitting or lying positions, wearing compression stockings, increasing salt and fluid intake (if not contraindicated), and using supportive devices like walkers. Patients should also be cautious with hot baths or showers, as heat can further lower blood pressure, and should avoid alcohol, which exacerbates these effects.
Most cases of MSA are sporadic, meaning they occur without a clear family history or inheritance pattern. While genetic variants in genes like SNCA and COQ2 have been studied and may slightly increase risk, they are not deterministic. Therefore, routine genetic testing for family members is generally not recommended unless there is a strong, unusual family history of similar neurodegenerative disorders. The condition is not considered a direct hereditary disease in the traditional sense.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

Meyahealth

Ⓒ 2026. All rights reserved by MEYA

About UsTerms & PolicyFAQ