Multiple system atrophy (MSA) is the current name for disorders once known individually as striatonigral degeneration, sporadic olivopontocerebellar atrophy, and the Shy-Drager syndrome. MSA is a progressive neurodegenerative disorder characterized by symptoms of autonomic nervous system failure (such as lightheadedness or fainting spells, constipation, erectile failure in men, and urinary retention) combined with tremor and rigidity, slurred speech, or loss of muscle coordination. MSA affects both men and women, primarily in their 50s. It can progress swiftly or slowly, but people with MSA generally survive for 9 years after the appearance of symptoms. There is no remission from the disease.

There is no specific treatment for nerve degeneration in MSA. Levodopa, used to treat rigidity and tremor in Parkinson's disease, may offer some help. However, striatonigral degeneration does not respond well to levodopa. Dopamine and anticholinergic drugs may be prescribed to treat spasms. Orthostatic hypotension may be treated with flucortisone and other drugs that raise blood pressure. Increased dietary fiber intake or use of laxatives may relieve constipation, and drugs or a penile implant may help with male impotence. A routine of stretching and exercise can help retain muscle strength and range of movement. An artificial feeding tube or breathing tube may be surgically inserted for management of swallowing and breathing difficulties.

MSA is a progressive disorder and most patients have a life expectancy after diagnosis of about 10 years or less.

Prepared by the National Institutes of Health