Multiple System Atrophy

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Symptoms & Signs

• Dizziness or fainting when arising or after standing still
• Impotence
• Loss of sweating of any part of the body
• Loss of control of bowels or bladder
• Vision changes, decreased or blurred vision
• Muscle rigidity
  • Stiffness
  • Difficulty bending arms or legs
• Posture difficulties: may be unstable, stooped, or slumped over
• Movement difficulties
  • Loss of balance
  • Gait (walking pattern) changes
  • Shuffling
• Slow movements
  • Difficulty beginning to walk or initiating any voluntary movement
  • Small steps followed by the need to run to maintain balance
  • Freezing of movement when the movement is stopped, unable to resume movement
• Muscle aches and pains (myalgia)
• Tremors: may be present in varying degrees or may not be present
  • May occur at rest or at any time
  • May become severe enough to interfere with activities
  • May be worse when tired, excited, or stressed
  • Finger-thumb rubbing (pill rolling tremor): may be present
  • May occur with any action such as holding a cup or other eating utensils
• Changes in facial expression
  • Reduced ability to show facial expressions
  • "Mask" appearance to face
  • Staring
  • May be unable to close mouth
• Voice and/or speech changes
  • Slow speaking
  • Voice is low-volume
  • Monotone
  • Difficulty speaking
• Difficulty chewing or swallowing (occasionally)
• Loss of fine motor skills
  • Difficulty writing: may be small and illegible
  • Difficulty eating
  • Difficulty with any activity that requires small movements
• Frequent falls
• Mild decline in intellectual function (may occur)

• Depression
• Confusion
• Dementia
• Seborrheic dermatitis
• Breathing difficulties due to vocal cord paralysis