Multiple system atrophy

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Central nervous system

Shy-Drager syndrome; Neurologic orthostatic hypotension; Shy-McGee-Drager syndrome; Parkinson's plus syndrome

There is no cure for MSA, and there is no known way to prevent the disease from getting worse. The goal of treatment is to control symptoms.

Anticholinergic medications may be used to reduce early or mild tremors. Levodopa may improve movement and balance.

Carbidopa may reduce the side effects of Levodopa and make it work better. However, the response to medications may be disappointing. Many affected individuals respond poorly to treatment with anticholinergics or Levodopa.

Medications that may be used to treat low blood pressure include:

• Vasoconstrictors (midodrine)
• Beta-blockers
• MAO inhibitors
• Vasopressin
• 9-fluohydrocortisone

A pacemaker programmed to stimulate the heart to beat at a rapid rate (faster than 100 beats per minute) may increase blood pressure for some people.

Constipation can be treated with a high-fiber diet and laxatives. Impotence may be treated with drugs that enhance erections.

The outcome is poor. Loss of mental and physical functions slowly get worse. Early death is likely.

• Progressive loss of ability to walk or care for self
• Difficulty performing daily activities
• Injuries from falls/fainting
• Side effects of medications

Call your health care provider if you develop symptoms of this disorder.

Call your health care provider if you have been diagnosed with MSA and your symptoms recur, worsen, or progress. Also call if new symptoms appear, including possible side effects of medications:

• Involuntary movements
• Nausea/vomiting
• Dizziness
• Changes in alertness/behavior/mood
• Severe confusion or disorientation
• Delusional behavior
• Hallucinations
• Loss of mental functioning

See also the specific medication for possible side effects.

Consult with your health care provider if you have a family member with this disorder and his or her condition deteriorates to the point that you are unable to care for the person at home.

Review Date: 11/21/2006
Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.