communication difficulties - speech problems, voice difficulties.
cognition/mood difficulties - apathy, depression, anxiety, irritability, emotional lability, executive dysfunction, slowness of thought
sleep disturbances - insomnia, REM sleep behaviour disorder, excessive daytime sleepiness, restless legs syndrome, nocturnal stridor (needing CPAP, tracheostomy in severe cases).
Prevalence
The prevalence of MSA is 4.4 per 100,000
average age of onset is around 55
average life expectancy is seven to 10 years from onset of symptoms.
Cause
The underlying cause of MSA is not known
collections of an abnormal protein in the brain, called alpha-synuclein, cause damage to cells
regions of the brain that control movement and autonomic functions are affected.
Diagnosis
MSA is difficult to diagnose.
Patients with MSA present with parkinsonian symptoms of slowness of movement, difficulty initiating movement, and rigidity with or without resting tremor.
Patients with MSA differ from Parkinson’s Disease with rapid progression of their disorder, absent/poor/waning response to levodopa, early instability/falls, early dysphagia and/or dysarthria.
Cures or treatments
Possible cures for MSA are being researched. Currently, there are a number of symptomatic therapies available which can help to improve quality of life.
Medications
Appropriate medications for symptomatic management continue to evolve and it may be beneficial to consult with a Neurologist and/or Geriatrician
high levodopa in some circumstances has limited effect, and may worsen autonomic problems
atropine eye drops or atrovent nasal spray administered under the tongue may assist in drying excess secretions/assist with drooling, medications to assist with constipation
medications may assist with constipation.
Non-pharmacological treatments
Orthostatic hypotension - compression stockings, custom-made elastic body garments, sufficient fluid intake, high-salt diet, spreading of total carbohydrate intake and head-up tilt during sleep
constipation - daily movement, sufficient fluid and fibre intake.
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