Multiple system atrophy causes and risk factors

Many diseases cause degeneration in different parts of the nervous system without an identifiable external cause. Genetic factors are known to involve in several, but the cause is still unknown for majority. Clinical features depend on which structures are affected. At this article we will explain major Multiple system atrophy causes, symptoms and will provide sample treatment plan for this disease.

Degeneration of the cerebral cortex causes dementia, the most common type being Alzheimer’s disease. Degeneration of basal ganglia results in movement disorder, which may manifest as either too little or too much movement, depending on the structured involved. Examples of these conditions are Parkinson’s disease.

Basal ganglia is affected by number of degenerative diseases, which present with differing combinations of slowness of movement, increased tone, tremor and loss of postural reflex. The most common cause of these parkinsonian or a kinetic-rigid syndrome is idiopathic Parkinson’s disease. This condition has an annual incidence of about 0.2/1000 and prevalence of 1.5/1000 in United Kingdom.

Its prevalence rate is same throughout the world. 10 % of patients are under 45 years at presentation, the incidence and prevalence both increase with age, the latter rising to over 1% in those over 60. Sex incidence is about equal. It is less common in cigarette smokers.

There are many conditions, which can rarely manifest as parkinsonian syndromes, including other degenerative diseases and infective diseases. Drug-induced Parkinsonism is much more common. These conditions should always be borne in mind in the differential diagnosis. In particular, several specific degenerative conditions can mimic idiopathic Parkinson’s disease, particularly in the early stage. The variants are notable in causing a more rapid clinical deterioration than idiopathic Parkinson’s diseases and being more resistant to treatment with dopaminergic medication.

Multiple system atrophy (MSA)

This is a sporadic condition seen in middle-aged and elderly patients. Features of Parkinsonism, often without tremor, are combined with varying degrees of autonomic failure, cerebellum involvement and pyramidal tract dysfunction. The combination of Parkinsonism with autonomic failure was called shy- dragger syndrome. In 1996, shy drager syndrome came into sub type of MULTIPLE SYSTEM ATROPHY, but this term is declining in use.

Degeneration is more widespread than idiopathic Parkinson’ s disease, and the disappointing response to levodopra and other anti-parkinsonian drugs is because of degeneration of post-synaptic neurons in basal ganglia. An autonomic feature includes postural hypotension, sphincter disturbance and sometimes respiratory-stridor; diagnosis is often assisted by performing tests of autonomic function.

Management of postural hypotension includes physical measures such as head-up sleeping position and compression stockings and drugs such as fludrocortisones and midodrine. Falls are much more common than in idiopathic Parkinson’s disease, and life expectancy is considerably reduced.

The symptoms of MULTIPLE SYSTEM ATROPHY include the postural hypotension, autonomic failure, orthostatic hypotension, impotence, impotence, constipation or diarrheas, speech problem, difficulties in breathing, swallowing problem. Many people have OPCA-olivopontocerebellar atrophy. It makes the patients to have imbalance, difficulty to coordinate with others.

The patients have slow movement and their muscles are stiff. They have acute adrenal characteristics; feel fatigue, nausea, abdominal pains, fever, and weight loss. They have problem such as urinary incontinence. Many patients have coloured skin of face, gums, tongue, arms, waist and knees. They are usually bronze in colour.


The chances of shy drager disease increased with these risk factors.

  • Age, If patient age is 50 or above
  • History, Patients with medical history of polio
  • Gender, Men are more prone to be infected.
  • Non-smoker
  • High level of cholesterol – Patients with high cholesterol are also at risk.
  • Drinking alcohol, it lower blood pressure and this increases the risk of MULTIPLE SYSTEM ATROPHY.
  • Diabetics

Treatment of Shy-Drager Disease

24-hour bed rest recommended to the patient for quick relief. For this disease, it is important to consult doctor for proper treatment. Treatment includes the family history and medical condition in detail. Doctors might ask many questions to know the real cause. After diagnosis doctor, follow the treatment plan as according to the condition.


The diagnosis is made clinically but is supported by the atrophy on CT scan or PET scan, MRI scan, urine test and complete blood test.

Shy Drager syndrome treatment plan includes:

  • Symptomatic treatment.
  • Anti-parkinsonian drugs.
  • Levodopa.
  • Diet including high amount of salt.
  • Soft diet.
  • Drugs for blood pressure increase.
  • Alpha-adrenergic drugs.
  • Non-steroidal anti-inflammatory medications.
  • Head raised sleeping method.
  • Stretching exercise.
  • Artificial feeding tube.
  • Artificial breathing tubes or inhaler.
  • Physiotherapies.
  • Sittings with different therapists such as speech therapist, physiatrists, etc.

To maintain patient’s mobility it is important to provide them physiotherapy. Patients for an easy can carry walker to help in walk and avoid the falls and to main the gait. Patients must walk slowly and stand up slowly. They must do pumping on ankle for blood circulation.

Multiple system atrophy is a progressive disorder. These patients have small life expectancy. Mostly after diagnosis, they can live up to 6-10 years or even less.

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