Multisystem Atrophy

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Diagnosis

Differentiating MSA from Parkinson's disease can be difficult. Diagnosis is often based on evaluating clinical symptoms and conducting brain imaging. After death, MSA can easily be identified by pathological examination of the brain tissue during autopsy.

Striatonigral degeneration, in particular, is often misdiagnosed as Parkinson's since the clinical symptoms are so similar. The most noticeable difference is that it does not respond to Parkinson's treatment. In some cases, its characteristic cerebellar atrophy (wasting of the cerebellum) can be viewed on an MRI scan, CT scan, or PET scan.

Other disorders (e.g., tumors, multiple sclerosis, alcoholism) can be confused with MSA.

Treatment

Treating MSA is difficult because it is not responsive to levodopa therapy (the treatment of choice for Parkinson's disease). In some cases, levodopa may have some benefit early in the course of the disease, but the response is generally short-lived.

Other medications may be used to alleviate particular symptoms, such as the orthostatic hypotension or urinary incontinence in Shy-Drager syndrome.

Physical, occupational, and speech therapy have all proven helpful for maintaining mobility in the early stages of Parkinson's and they may be helpful in treating MSA as well.

Please contact the National Institute of Neurological Disorders and Stroke for more information and resources on multiple system atrophy.

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