VERIFIED CONTENTAuthor: lek. Tomasz Nęcki

Multiple system atrophy (MSA) is often similar to Parkinson's in terms of its symptoms, but is different from Parkinson's in that it is a much more serious condition. So read the causes and symptoms of multi-system atrophy, and learn how to heal.

Multiple system atrophy(MSA, multiple system atrophy) is one of the neurological conditions for which medical treatments still lack effective treatments. This unit, due to some similarities to Parkinson's disease, is sometimes classified as the so-called atypical parkinsonisms.

Some scientistsmulti-system decayis actually treated as a broader term - some scientists generally recognize thatmulti-system decayare three similar to problems, which are the Shy-Drager syndrome, olive-pontocerebellar atrophy and nigrostriatal degeneration.

Typicallymultiple system atrophyoccurs in people between the ages of 50 and 60, but it is possible that they will develop the disease at an earlier age. Statisticallymultiple system atrophyoccurs in about 5 out of 100,000 people, men are more likely to suffer from this disease.

Multiple system loss: causes

The symptoms ofatrophyare caused by changes in the nervous tissue. In the course of the disease, there is a progressive loss of neurons and oligodendrocytes, the losses of these elements of the nervous tissue are replaced by astrocytes - such pathologies occur in many different places within the central nervous system (including the substantia nigra, striatum, inferior salivary nucleus) or in the cerebellum).

These are not the only phenomena occurring in the course ofmulti-system atrophy- in the histopathological examination of the nervous tissue of a patient suffering from this unit, it is possible to find intracellular, silver-absorbing inclusions, as well as to observe the phenomenon referred to as gliosis.

In what mechanisms the pathologies described above occur - this still remains a mystery. Scientists are looking for the causes ofmulti-system decaye.g. in genetic mutations or autoimmune disorders. Some also postulate that it is a diseaseexposure to pesticides or having a head injury may contribute. An unequivocal answer to what is the cause ofmulti-system failure , no one is able to provide an answer at the moment.

Multiple System Atrophy: Symptoms

In the course ofmultiple system atrophythere are three groups of complaints: patients may experience parkinsonian symptoms, autonomic nervous system disorders and cerebellar disorders. Usually, the first problems appear to be symptoms that can lead to a patient misdiagnosing - most patients withmultiple system atrophy (consisting mainly in difficulties with the initiation of some motor activity).

Othersymptoms of multi-system atrophymay appear in patients in various configurations and may be:

  • muscle stiffness
  • tremors
  • ataxia (impaired motor coordination)
  • balance problems
  • sweating disorders and related disorders of body temperature regulation
  • orthostatic hypotension (a phenomenon that is quite dangerous for the he alth of patients, because sudden drops in blood pressure can lead to fainting and related falls)
  • impotence
  • urination disorders (which can include both urinary incontinence and fluid retention in the bladder)
  • constipation
  • vocal cord paralysis
  • dry mouth
  • dyzartria
  • breathing disorders during sleep (related to e.g. extremely loud snoring or assuming the form of sleep apnea)
  • speech disorder
  • nystagmus
  • one-way tilting of the torso (referred to as the sign of the leaning tower of Pisa)

Symptoms of multiple system atrophymay appear in various sequences, but it is characteristic of this individual that over time the patient's condition deteriorates constantly and the patient's condition becomes increasingly severe. disabilities.

Multiple system loss: diagnostics

It has been mentioned above that in patients withmulti-system atrophyit is possible to find characteristic deviations in microscopic examination of the nerve tissue. Such analyzes, however, are not carried out vividly - for this reason, it is possible to make a certain diagnosisof multi-system decayonly posthumously.

Same symptomsof decaymulti-systemare not unique to this disease - similar ailments may be encountered, for example, in Parkinson's disease, but also in demyelinating diseases, prion diseases or in the course of infections of the central nervous system. For this reason, in patients with suspectedmulti-system atrophyit is very important to perform a detailed differential diagnosis.

The most difficult thing is to differentiatemultiple system atrophyfrom Parkinson's disease - some researchers believe that the criterion differentiating these two entities could be the patient's response to levodopa treatment (in the case of Parkinson's disease improves the condition of patients after this drug, while inmulti-system atrophyusually no improvement is observed after using this drug).

Due to the aforementioned necessity to differentiatemultiple system atrophy , patients may undergo various examinations - for example, imaging examinations, such as computed tomography or magnetic resonance imaging of the head. In the abovementioned studies, deviations may be observed (it is possible, for example, to reduce the size of the cerebellum or the bridge), however, it also happens that the obtained images of the brain of patients withmulti-system atrophydo not show any abnormalities.

The disease is quite rare and therefore it is only diagnosed when other - more likely causes of the patient's symptoms - have been ruled out.

Multiple System Atrophy: Treatment

Currently, no causal treatment for multiple system atrophy is available. Patients suffering from this unit, however, are offered symptomatic treatment, the aim of which is to reduce the intensity of their ailments and improve their quality of life.

For patients with multiple system atrophy, physiotherapy is very important, thanks to which it is possible to maintain physical fitness as long as possible and prevent the occurrence of contractures. The so-called gait training, sometimes it is beneficial to use walking aids, such as walkers. In the case of speech disorders, it may be helpful to conduct speech training - for this purpose, you can use the services of a speech therapist.

Pharmacological preparations are also used in the symptomatic treatment of multiple system atrophy. Patients with impaired urination may be prescribed, for example, oxybutonin (an anti-incontinence agent). In the case of extremely severesymptoms of parkinsonism, it is possible to try to administer levodopa preparations to patients ( although the percentage of improvement obtained with such treatment is quite low).

Due to the relatively high risks associated with orthostatic hypotension, great emphasis is placed on preventing drastic pressure drops in patients with multiple system atrophy. Increasing fluid intake and adding more s alt to the diet can reduce the incidence of this problem.

Patients are sometimes advised to use compression tights, and they are warned against factors that may lower blood pressure (such as alcohol consumption or dehydration). Orthostatic hypotension can also be prevented by administering drugs such as fludrocortisone (belonging to the mineralocorticoid group) or midodrin (a substance that stimulates alpha-adrenergic receptors).

Multiple system atrophy: prognosis

The prognosis of patients with multiple system atrophy is unfortunately unfavorable - the disease has no remission periods, only its constant, rapid progression occurs. The average survival time of patients from the onset of the first symptoms of the disease is about 6 to 9 years.

Category:

Neurology