Multiple System Atrophy (MSA) is a debilitating neurodegenerative disease. It is rare, affecting only about four in 100,000 people, but its impact on those it touches is devastating. MSA shares many pathologic and clinical features with the better-known and more common Parkinson’s disease, for which it is often mistaken. In fact, the abnormal protein in Parkinson’s disease (synuclein) also plays a key role in MSA.

There are three types of MSA:

  • Parkinsonian, in which patients are affected mostly with severe symptoms similar to Parkinson’s disease such as slow movement, problems walking, stiff muscles and tremor
  • Cerebellar, in which patients have problems primarily with coordination, walking and slurred speech
  • Combined, in which patients suffer from both parkinsonian and cerebellar symptoms


In addition to the movement symptoms specific to each type of MSA, MSA can cause, fainting and low blood pressure (as well as fluctuations in blood pressure), muscle contractions, urinary incontinence, constipation, sexual dysfunction, double vision or other vision disturbances, difficulty breathing and swallowing, sleep disturbances including sleep apnea, and abnormal sweating. There is no cure for MSA, and lifespan with the disease typically ranges between 7-10 years.


MSA progresses rapidly and treatment is aimed at trying to control symptoms, which is challenging. There are viable treatments for a number of MSA symptoms, however, and a coordinated care approach is important to optimize care.

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Reviewed by a Cleveland Clinic medical professional.

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