Editing Multiple system atrophy (section)

{{Short description|Neurodegenerative disorder}}
{{cs1 config|name-list-style=vanc |display-authors=6}}
{{use dmy dates|date=October 2024}}
{{Infobox medical condition
| name = Multiple system atrophy
| image = MSA aSynuclein.jpg
| caption = [[Alpha-synuclein]] immunohistochemistry of the brain showing many [[glial]] [[inclusion bodies]]
| field = [[Neurology]]
| symptoms = [[Parkinsonism]], [[xerostomia]], [[dysautonomia]], [[ataxia]]
| complications = [[Cardiac arrest]], [[infection]]s, [[aspiration pneumonia]]
| onset = 50–60 years
| duration = Long term
| types = {{Flatlist|
* MSA-P
* MSA-C
}}
| causes = Unknown
| diagnosis = [[MRI]], [[CT scan]], [[autopsy]]
| treatment = [[Physical therapy]], [[hospice care]]
| medication = [[L-DOPA]], [[fludrocortisone]], [[midodrine]]
| prognosis = Life expectancy 6–12 years after onset of symptoms
| frequency = 5 per 100,000 people
}}

'''Multiple system atrophy''' ('''MSA''') is a rare [[neurodegenerative disorder]]<ref>{{DorlandsDict|one/000010201|Multiple system atrophy}}</ref> characterized by [[tremor]]s, [[bradykinesia|slow movement]], muscle rigidity, [[postural instability]] (collectively known as [[parkinsonism]]), [[autonomic dysfunction]] and [[ataxia]]. This is caused by progressive degeneration of [[neuron]]s in several parts of the [[brain]] including the [[basal ganglia]], [[inferior olivary nucleus]], and [[cerebellum]]. MSA was first described in 1960 by [[Milton Shy]] and [[Glen Drager]] and was then known as '''Shy–Drager syndrome'''.<ref>{{Cite web |title=Multiple System Atrophy-D Maybe Something Altogether–Different |url=https://practicalneurology.com/articles/2018-mar-apr/multiple-system-atrophy-d-maybe-something-altogetherdifferent |access-date=2025-01-11 |website=Practical Neurology |language=en}}</ref>

Many people affected by MSA experience dysfunction of the [[autonomic nervous system]], which commonly manifests as [[orthostatic hypotension]], [[impotence]], [[anhidrosis|loss of sweating]], [[dry mouth]] and [[urinary retention]] and [[urinary incontinence|incontinence]]. [[Palsy]] of the [[vocal cords]] is an important and sometimes initial clinical manifestation of the disorder.

A [[prion]] of the [[alpha-synuclein]] protein within affected neurons may cause MSA.<ref name="pmid29743672"/> About 55% of MSA cases occur in men, with those affected first showing symptoms at the age of 50–60 years.<ref name=":0" /> MSA often presents with some of the same symptoms as [[Parkinson's disease]]. However, those with MSA generally show little response to the [[dopamine agonist]]s used to treat Parkinson's disease and only about 9% of MSA patients with tremor exhibit a true parkinsonian pill-rolling tremor.<ref>{{cite web|title=Multiple System Atrophy Clinical Presentation|url=https://emedicine.medscape.com/article/1154583-clinical#b4|access-date=January 7, 2018}}</ref>

MSA is distinct from [[multisystem proteinopathy]], a more common muscle-wasting syndrome. MSA is also different from [[multiple organ dysfunction syndrome]], sometimes referred to as multiple organ failure, and from multiple organ system failures, an often-fatal complication of [[septic shock]] and other severe illnesses or injuries.