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Multiple system atrophy

  • Alternative Names

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


    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 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. Impotence may be treated with drugs that enhance erections.

    Support Groups

    Expectations (prognosis)

    The outcome is poor. Loss of mental and physical functions slowly get worse. . Early death is likely. The typical survival time from the time of diagnosis is 7 to 9 years.

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

    Calling your health care provider

    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

    Contact 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.