Multiple System Atrophy (MSA) or Shy Drager Syndrome: Causes, Symptoms, Diagnosis, Treatment, Prognosis

Brain– The main organ of the human body which is responsible for our body functioning normally. It is the central part of our nervous system. It is responsible for making human beings capable of thinking, differentiating us from other living things in the planet. As one ages, like other parts of the body, the brain also starts degenerating, which may result in many medical conditions. One such condition is Multiple System Atrophy or Shy Drager Syndrome in which there is degeneration of nerve cells in and around the brain affecting various functions of the body. In this article, we will discuss in detail the causes, symptoms, and possible treatments of Multisystem Atrophy or Shy Drager Syndrome.

Multiple System Atrophy (MSA) or Shy Drager Syndrome is a degenerative neurological disease. Multiple System Atrophy is developed as a result of degeneration of nerve cells in some specific areas of brain. This degeneration of cells results in issues with movement, balance, and other functions of body such as bladder control or regulation of blood pressure.

The exact cause of Multiple System Atrophy or Shy Drager Syndrome is still unknown and to date no exact risk factors have been identified. It is generally found to occur in males in an average age range of around 55. Multiple system atrophy generally presents itself with symptoms similar to Parkinson’s disease; however, unlike in Parkinson’s disease individuals with Shy Drager Syndrome usually exhibit very minimal response to medications which are used for Parkinson’s disease.

As stated, the exact cause of Multiple System Atrophy or Shy Drager Syndrome is unknown, but it is mostly found in males aging approximately 50 to 60 years.

Since Multiple System Atrophy or Shy Drager Syndrome impairs the nervous system of the body, some of the symptoms to look out for are:

• Masked facies
• Inability to close mouth
• Reduced facial expressions
• Staring episodes
• Difficulty with chewing or swallowing
• Impaired sleep patterns
• Dizziness or unconscious episodes when standing after prolonged sitting
• Frequent falls
• Impotence
• Loss of bowel and bladder control
• Reduced fine motor skills
• Problems with legible writing
• Loss of sweating
• Mild cognitive decline
• Movement impairment
• Gait imbalance
• Myalgias
• Muscle rigidity
• Difficulty with bending the extremities
• Nausea
• Postural difficulties
• Slowed movements
• Freezing episodes
• Tremors
• Vision changes
• Speech changes
• Dysarthria
• Confusion
• Dementia
• Depression

To confirm the diagnosis of Multiple System Atrophy or Shy Drager Syndrome, the health care provider may perform a detailed physical examination to look at the muscles and nerves.

Orthostatic blood pressures will be checked looking for changes in blood pressures when lying down and standing up.

There are no particular investigations to confirm Multiple System Atrophy or Shy Drager Syndrome, but a diagnosis can be made depending on:

• History and clinical presentation
• Physical examination
• Ruling out other causes of the symptoms

Some other testings that may help confirm the diagnosis of Multiple System Atrophy or Shy Drager Syndrome are as follows:

• MRI of head
• Plasma norepinephrine levels
• Urinalysis to look for urine catecholamines

There is no cure found to date for Multiple System Atrophy or Shy Drager Syndrome and there is no specific way to prevent this disease from progressing. The main aim of the treatment is to control symptoms. Anticholinergic drugs may be used to control tremors. Carbidopa-Levodopa is used for movement and balance.

Medications are also given to treat low blood pressures like beta-blockers, Florinef, midodrine, etc.

The overall prognosis outlook for Multiple System Atrophy or Shy Drager Syndrome is poor as the disease is progressive impairing mental and physical functions gradually. Generally, individuals with this disease may survive up to 8-9 years after its diagnosis.

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