If Anyone Is Interested, M.S.A.; A Terrible Disease

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For those of you who follow me I thought maybe you would like to know a little bit about M.S.A. This illness is what my brother, Al has. It is not a fun disease, as most aren’t. This disease shortens the life by years and affects so much of the body.

I have spoken about it but it is a rare disease, so I thought I would share with you what I have learned.


Multiple system atrophy (MSA) is a rare condition that causes symptoms similar to Parkinson’s disease. However, patients with MSA have more widespread damage to the part of the nervous system that controls important functions such as heart rate, blood pressure, and sweating.


The cause is unknown. MSA develops gradually and is most often diagnosed in men older than 60.


MSA damages the nervous system. Symptoms can include:

  • Face changes
    • “Mask” appearance to face
    • May be unable to close mouth
    • Reduced ability to show facial expressions
    • Staring
  • Difficulty chewing or swallowing (occasionally)
  • Disrupted sleep patterns (especially during rapid eye movement (REM) sleep late at night)
  • Dizziness or fainting when standing up or after standing still
  • Frequent falls
  • Impotence
  • Loss of control over bowels or bladder
  • Loss of fine motor skills
    • Difficulty eating
    • Difficulty with any activity that requires small movements
    • Writing that is small and hard to read
  • Loss of sweating in any part of the body
  • Mild decline in mental function
  • Movement difficulties
  • Muscle aches and pains (myalgia)
  • Muscle rigidity
    • Difficulty bending arms or legs
    • Stiffness
  • Nausea and problems with digestion
  • Posture difficulties: may be unstable, stooped, or slumped over
  • Slow movements
    • Difficulty beginning to walk or starting any voluntary movement
    • Freezing of movement when the movement is stopped, unable to start moving again
    • Small steps followed by the need to run to keep balance
  • Tremors
    • May become severe enough to interfere with activities
    • May be worse when tired, excited, or stressed
    • May occur at rest or at any time
    • May occur with any action, such as holding a cup or other eating utensils
    • Finger-thumb rubbing (pill rolling tremor)
  • Vision changes, decreased or blurred vision
  • Voice and speech changes
    • Difficulty speaking
    • Monotone
    • Slow speaking
    • Voice is low volume

Other symptoms that may occur with this disease:

Exams and Tests

Your doctor or nurse will examine you, and check your eyes, nerves, and muscles.

Your blood pressure will be taken while you are lying down and standing up.

There are no specific tests to confirm this disease. A neurologist can make the diagnosis based on:

  • History of symptoms
  • Physical examination results
  • Ruling out other causes of symptoms

Testing to help confirm the diagnosis may include:


There is no cure for MSA. 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 is usually added to Levodopa to reduce its side effects and make it work better. However, for people with MSA the response to medications may be disappointing. Many people respond poorly to treatment with anticholinergics or Levodopa.

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

  • Beta-blockers
  • Fludrocortisone (Florinef)
  • MAO inhibitors
  • Vasoconstrictors (midodrine)
  • Vasopressin

A pacemaker that is 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. Medicines are available to treat impotence.

Outlook (Prognosis)

The outcome is poor. Loss of mental and physical functions slowly get worse. Early death is likely. Patients typically live 7 to 9 years after diagnosis.

Possible Complications

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

When to Contact a Medical Professional

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 return or get worse. Also call if new symptoms appear, including possible side effects of medications:

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


23 thoughts on “If Anyone Is Interested, M.S.A.; A Terrible Disease

    • yes it is a bad disease, and every day we deal with different parts of it. I just learned today that Al has been seeing through double vision. I also learned that this is part of the M.S.A.


      • it is very horrible,nasty disease.my husband(his name Al too,Allan)got this disease,and we both going thru very hard ,most horrible time ,can put right words.I know Terry what you going thru ,god bless you and give you strength,sorry for spelling ,english not my first languge


  1. just one year ago, I wrote a newspaper profile story on an incredible man who has MSA living in Fairport NY. Before I interviewed coach Brown, I also had no awareness of the disease, it is horrible and I am so sorry your brother Al. here is the link to my story on Coach Brown from last year: I hope that this is a comfort that though this is a rare disease, your brother is not alone in his suffering: http://wp.me/pXO6C-QQ


  2. Thank you Terry for the information. I follow another blogger (busymindthinking) who just got a diagnosis for her mysterious medical symptoms that have her wheelchair bound. Thank you for taking care of Al. You are his Angel.


  3. What a list, this disease is not jus tone part of the body but all, how awful for Al, I can understand his frustration and his wish to go! And you watching it every day! Frustrating for you too! big hugs!


    • it is very hard to watch him and even worse to watch him try to go back in time. He will deliberately let loose of what he is too hold on because he thinks he can walk or take too big of bites. I understand what he is thinking but it also forces me to stay on top of things much more closely


  4. Terry,
    I haven’t been around much lately and I’m so surprised about the MSA. Didn’t Al originally have the diagnosis of Parkinson’s? What made them re-evaluate? Has it been a while or have I just missed it? Your post was quite an education; there is so much similarity between the two diseases. It seems the major difference is response to levadopa/carbadopa and speed of disease progression. Am I right? Either way, I’m so sorry for Al and for you but also touched by your devotion, inspired by your spirit and impressed by your strength. Prayers for you both.


    • yes he was diagnosed in the beginning with PD. After years go by there are specific ways to tell the differences between the two, making it clearly one or the other. M.S.A. hits the spinal column affecting three major areas of the body. Ex. Al’s heart rate can beat 300 per minute, as that part of his body has been damaged controlling the heart. PD affects the brain only. Thank you for the prayers.


  5. Pingback: Faster Than A Hummingbird | terry1954

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