What is Multiple System Atrophy (MSA)?
In Multiple System Atrophy, there is widespread autonomic failure associated with impairment in other neurological systems. The other neurological systems may be cerebellar, extrapyramidal, neuromuscular, or pyramidal. The pathological hallmark of MSA is neuronal loss and gliosis within multiple sites in the brain. The prognosis is more guarded in the Multiple System Atrophy patient than in Pure Autonomic Failure. It is rare for a patient to survive 10 years. The autonomic abnormalities are seldom the direct cause of death. A significant number of patients develop laryngeal stridor and difficulty swallowing, which can lead to pneumonia. In addition, many patients with MSA experience Cheyne-Stokes or periodic respiration and in some cases this may lead to a critical loss of respiratory drive. Pulmonary hypertension may occur during apnea. The most common causes of death in patients with MSA are pulmonary embolus, apnea, and intercurrent infection.
