Multiple System Atrophy occurs because of environmental toxin accumulation. It causes brain shrinkage in certain portions of your brain (the cerebellum, basal ganglia, and brainstem). These brain areas are responsible for regulating internal body function, digestion, and motor control.

The neurons seen under a microscope seem to have an abnormal protein alpha-synuclein. Studies reported that this protein is overexpressed in Multiple System Atrophy.

Multiple System Atrophy affects many parts of your body. Symptoms are likely to develop at the age of 50 or 60. Multiple system atrophy is of two types, namely, Parkinsonian and cerebellar. The type is identified at the time of diagnosis.

The Parkinsonian type:

The symptoms are similar to those present in Parkinson’s, such as:

• Muscle rigidity
• Difficulty while bending your hands and feet
• Movement slow (bradykinesia)
• Tremors occur rarely compared to the symptoms seen in classic Parkinson’s disease
• Posture and balance problems

The cerebellar type:

Here, muscular coordination is the primary issue. However, other symptoms may include:

• Movement impairment and coordination, like unsteady gait and loss of balance.
• Slow, slurred speech or low-volume speech.
• Blurred and double vision, difficulty focusing, symptoms related to visual disturbances.
• Difficulty chewing or swallowing (dysphagia).
• ● Postural hypotension, a type of low blood pressure that causes dizziness and lightheadedness or fainting while sitting, standing up, or lying down.
• Multiple system atrophy may cause autonomic body functions, including:

Urinary and bowel dysfunction

• Constipation
• Loss of bladder or bowel control

Sweating symptoms

• Decreased production of saliva, sweat, or tears
• Unable to tolerate heat because of reduced sweating
• Body temperature control impairment causing cold hands and feet

There may be some ambiguity in diagnosing Multiple System Atrophy. Some of the symptoms include rigid muscles and an unsteady gait. As they occur in combination in Parkinson’s disease too, diagnosing this disease is challenging. Autonomic and imaging studies, as part of a clinical examination, help your physician detect the disease.

If the physician suspects Multiple System Atrophy, a series of tests are performed like physical examination, blood tests, and brain imaging tests such as MRI. These tests show the possibility of your symptoms being related to Multiple System Atrophy.

Tilt table test

In case you have blood pressure symptoms, you are placed on a table and tilted at a 70-degree angle. Your blood pressure and heart rate are monitored during this test. The physician documents any irregular blood pressure with every change in physical position.

Tests for autonomic function

• Blood pressure measured while standing and lying down.
• A sweat test to study perspiration.
• Assessing bladder and bowel function.
• An electrocardiogram to detect the electrical signals of your heart.

The condition cannot be cured; however, it can be treated to improve body functions.

• Medications for blood pressure: Corticosteroid fludrocortisone, in combination with other medicines, amplifies your blood pressure, retaining water and salt.
• Medications to control Parkinson-like symptoms: Specific medications like levodopa and carbidopa effectively treat Parkinson’s disease like stiffness, balance problems, and slow movements. These medications improve a patient’s movements entirely.
• Managing breathing and swallowing difficulties: If you face swallowing or breathing difficulties, you will be surgically fed through a catheter inserted to drain your bladder.
• Therapy: As the disease progresses, a physical therapist can help maintain muscular functions and motor and muscle capacity. Speech therapists will improve your speech function.

The outcome is positive and focuses on mental and emotional well-being. Over-the-counter medications can relieve your symptoms.

For bradycardia, pacemakers are efficient. However, tracheostomy is performed in case of respiratory issues, especially in case of severe dysphagia. Surgical complications include injury to the blood vessels of the heart while operating.