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Best Treatment For Multiple System Atrophy

Various treatment options are available for the management of multiple system atrophy symptoms. As of now, there is no cure for multiple system atrophy and the treatment is to manage symptoms and improving quality of life.

Best Treatment For Multiple System Atrophy

There is no best treatment for multiple system atrophy. The condition cannot be cured, and the treatment is purely symptomatic. Simultaneous treatment to manage the symptoms is required. The treatment may or may not delay the progression of the disease. Further, the treatment best suitable for the patient is the best treatment for that particular patient. It may be the case that the treatment effect in one patient may not be effective in another patient. Further, all the patients do not have similar symptoms and the modifications in treatment are required for individual patients. The goal of the treatment is to effectively manage the symptoms of the disease and the treatment in terms of drugs or dosage changes as the disease progresses.

There is presently no option available in medical science that can cure the multiple system atrophy. This is due to the complex nature of the disease and its widespread expansion in the brain. The treatment is quite complex and is generally directed towards the relief of the symptoms and improvement in the quality of life. The options for slowing the progression of the disease are less and the progression of the disease varies from patient to patient. This results in poor prognosis of this condition. The survival time after the diagnosis is done, is usually less than 10 years.

Following are the treatment options available to the patient-

Antihypotensive Drugs– Low blood pressure is a common symptom of multiple system atrophy.1 Various drugs are used to treat increases blood pressure. Some drugs such as fludrocortisone retain blood pressure by increasing the retention of salt and water.

Pacemaker– Although rarely used and also rarely helpful, this device prevents sudden death or other complication due to very low blood pressure. The pacemaker is implanted in those patients who are suffering from severe bradycardia along with orthostatic hypotension.

Sexual Dysfunction Treatment– Multiple system fatigues also affect sexual activity in patients.2 Drugs such as sildenafil help reduce the occurrence of erectile dysfunction.

Physical Therapy– As the muscles become stiff due to damage, the treatment of the therapy is done to prevent further progression of the stiffness. Thus, physical therapy and water exercise program help increase muscular activity. However, this is not advised in severe conditions where the patient is not able to make a balance. Therapy will help you to maintain the maximum functional capacity of motor neurons.

Fall– As the disease progresses, it starts severely impacting the muscles and as a result the risk of fall of patient increases. Thus proper instructions related to the fair are provided to the patient.

Difficulty Swallowing And Breathing– In the progressive conditions when the patient starts encountering a problem in swallowing as well as breathing, breathing tube or feeding tube is inserted. However, in severe conditions, gastrotomy is recommended through which the food is directly delivered in the stomach.

Bladder Problems– The urinary incontinence is tried to be managed with the medications and this strategy works for initial years when the disease is at a milder stage. Surgical intervention is required in the advanced condition in which a catheter is inserted to draw urine.

Lifestyle Modifications– In adjuvant to the medications, various lifestyle modifications also help in managing the symptoms of the condition and also provide energy to fight against the symptoms more effectively. Drinking coffee, avoiding heat and elevating the head while sleeping reduces the symptoms.


The treatment required for multiple system atrophy may be surgical and non-surgical. Non-surgical treatment includes drugs for managing the symptoms of parkinsonism, dystopia, cerebellar ataxia, pure autonomic failure condition such as orthostatic hypotension, postprandial hypotension, incomplete bladder emptying, urge incontinence, constipation, nocturnal polyuria, and erectile dysfunction.


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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 24, 2019

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