Multisystemic atrophy

Abstract

Multiple system atrophy (MSA) is a rare neurodegenerative disorder with disabling motor features and a wide range of non-motor and dysautonomic symptoms. Early-stage cases are especially difficult to diagnose as they may resemble other parkinsonisms or ataxic disorders. Possible or probable MSA can be diagnosed following clinical criteria, which include several neuroimaging techniques that may be helpful, though specificity and sensitivity is complicated to achieve at early stages. Besides imaging techniques functional studies assessing the autonomic, urinary symptoms, and sleep disorders may be helpful. There are no disease modifying treatments, and the available pharmacological treatment has limited efficacy and possible side effects that should be taken into account. Management of these patients should ideally be done in multidisciplinary teams with help from several professionals (neurologists, urologists, nurses, physiotherapists, among others).