Multiple System Atrophy

Multiple system atrophy is a neurological disorder that begins in adult life and is characterized by parkinsonism, cerebellar ataxia, and autonomic dysfunction in various combinations.

Parkinsonism refers to slowness of movement with muscle stiffness and sometimes tremor. In contrast to L-Dopa’s effectiveness in the treatment of Parkinson’s disease, in patients with Multiple System Atrophy, treatment with L-Dopa or dopaminergic agonists rarely improves parkinsonism significantly.

Cerebellar ataxia refers to impaired coordination and is caused by degeneration of the cerebellum.

Autonomic dysfunction causes orthostatic hypotension (fall in blood pressure upon standing up), bladder and bowel dysfunction, and impotence.

Parkinsonism and cerebellar ataxia commonly occur in combination. However, one of these features may predominate. When parkinsonism predominates, the term striatonigral degeneration is often used. When cerebellar features are more prominent, the term olivopontocerebellar atrophy is frequently used. When autonomic failure is the most prominent feature, the term Shy-Drager syndrome is often used. Multiple system atrophy shares many of the signs and symptoms of Parkinson’s disease. Thus, it is not surprising that multiple mystem mtrophy is frequently misdiagnosed as Parkinson’s disease. Indeed almost 10 percent of patients with suspected Parkinson's disease turn out to have multiple system atrophy.

Literature on multiple system atrophy

• Multiple System Atrophy
• Hypertensive cardiovascular damage in patients with primary autonomic failure

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