Multiple system atrophy

Abstract

Multiple system atrophy (MSA) is a slowly progressive neurodegenerative disease that is characterized by (i) a hypokinetic movement disorder, which is predominant in MSA of the parkinsonian type (MSA-P), or by (ii) cerebellar symptoms, which prevail in MSA of the cerebellar type (MSA-C). In both types, the movement disorder is accompanied by autonomic symptoms such as orthostatic hypotension or erectile dysfunction. The effect of dopaminergic medication on the parkinsonian symptoms is very limited. The disease progression is more rapid compared to Parkinson’s disease and is characterized by falls early in the disease course, as well as changes in articulation (dysarthria), swallowing (dysphagia), and the occasional stridor that can also help differentiate MSA-P from Parkinson’s disease.